Zachery Lavender, IDMT-P

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

2630 Central Ave
Eielson AFB, AK 99702-2301

Phone

(907) 377-7835

NPI assigned

Dec 20, 2023

Last updated

Oct 7, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759795200000",
    "number": "1487422390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2630 CENTRAL AVE",
            "city": "EIELSON AFB",
            "state": "AK",
            "postal_code": "997022301",
            "telephone_number": "907-377-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2630 CENTRAL AVE",
            "city": "EIELSON AFB",
            "state": "AK",
            "postal_code": "997022301",
            "telephone_number": "907-377-7835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "ZACHERY",
        "credential": "IDMT-P",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-20",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Rajaratnam Hughes
• Elias N Hydrick, D.O.
• Nichole Kilinc, PA-C
• Hannah Laurel Kopchinski, WFS
• Matthew Robert Kramer, IDMT
• Danielle A Lawson
• Theresa Ann Lawson, PH.D.
• Cody Scott Lemon
• Susan Liebig, RDH
• Taylor Ravoyd Liles, PT, DPT

• Independent Duty Medical Technicians in Eielson AFB, AK
• Providers in Eielson AFB, AK by specialty
• Independent Duty Medical Technicians in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.