Active NPI
Erik M Waldrip, IDMT
- Independent Duty Medical Technicians
- Cannon Afb, NM
National Provider Identifier
1538699418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Medical Technicians
- Practice address
- 104 W D. L. Ingram Ave
Cannon Afb, NM 88101 - Phone
- (277) 857-5784
- NPI assigned
- Jun 14, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Duty Medical Technicians | 1710I1003X | Primary |
Addresses
Primary practice location
104 W D. L. Ingram Ave
Cannon Afb, NM 88101
Mailing address
104 W D. L. Ingram Ave
Cannon Afb, NM 88101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659398400000",
"number": "1538699418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 W D. L. INGRAM AVE",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "88101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 W D. L. INGRAM AVE",
"city": "CANNON AFB",
"state": "NM",
"postal_code": "88101",
"telephone_number": "277-857-5784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDRIP",
"first_name": "ERIK",
"middle_name": "M",
"credential": "IDMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-14",
"last_updated": "2022-08-02",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1003X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Medical Technicians",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cannon Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.