Cameron Modisette

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

755 Scott Cir
Hickam Afb, HI 96853-5399

Phone

(808) 448-6203

Fax

(808) 448-6226

NPI assigned

Jul 29, 2009

Sex

Male

Sole proprietor

No

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": "1248825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248825600000",
    "number": "1639300312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "HICKAM AFB",
            "state": "HI",
            "postal_code": "968535399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 SCOTT CIR",
            "city": "HICKAM AFB",
            "state": "HI",
            "postal_code": "968535399",
            "telephone_number": "808-448-6203",
            "fax_number": "808-448-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODISETTE",
        "first_name": "CAMERON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-29",
        "last_updated": "2009-07-29",
        "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": []
}

• Melissa Sue Kruse, DDS
• Betsy Ann Lefebvre, DDS
• Jeffery Michael Lerma, PA-C
• Khara Maciel, RDH
• Lauren Nicole Mitchell, DPT, PT
• Kelly Anne O'Keefe, DDS
• Guillermo Enrique Orraca II, D.M.D.
• Jeanann Loranger Perkins, PA-C
• Mark P Picchione, IDMT
• Ila Sophie Reyes, M.D

• Independent Duty Medical Technicians in Hickam Afb, HI
• Providers in Hickam Afb, HI by specialty
• Independent Duty Medical Technicians in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2009; 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.