Johnetta Young, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

3458 Neely Rd
McGuire, NJ 08641-0000

Phone

(609) 754-9260

NPI assigned

May 13, 2009

Last updated

Apr 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Johnetta Bennefield Former name

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": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1528292992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3458 NEELY RD",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "08641",
            "telephone_number": "609-754-9260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3458 NEELY RD",
            "city": "MCGUIRE",
            "state": "NJ",
            "postal_code": "086410000",
            "telephone_number": "609-754-9260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "JOHNETTA",
        "name_prefix": "Ms.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "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": [
        {
            "first_name": "JOHNETTA",
            "last_name": "BENNEFIELD",
            "credential": "IDMT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jenoveva Orsini, A.P.N.

• Independent Duty Medical Technicians in McGuire, NJ
• Providers in McGuire, NJ by specialty
• Independent Duty Medical Technicians in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; 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.