Kimberley Dawn Bock Tabor, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

3453 Neely Rd
McGuire AFB, NJ 08641

Phone

(609) 754-9177

Fax

(609) 754-9177

NPI assigned

May 13, 2009

Last updated

Oct 26, 2010By 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

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": "1288051200000",
    "number": "1659505030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOLLY HILL DR",
            "city": "NEW EGYPT",
            "state": "NJ",
            "postal_code": "085332718",
            "telephone_number": "210-383-0748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3453 NEELY RD",
            "city": "MCGUIRE AFB",
            "state": "NJ",
            "postal_code": "08641",
            "telephone_number": "609-754-9177",
            "fax_number": "609-754-9177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOCK TABOR",
        "first_name": "KIMBERLEY",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2010-10-26",
        "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": []
}

• 87TH Medgrp-JB McGuire-Dix-Lakehurst
• Amanda Ammentorp, DO
• Jess Barrows, LCSW, LCADC
• Jennifer Bench, R.D.H.
• Stacey Keane Boden, LICSW
• Barbara D Broadt, RD
• Deon Bullard, MSW, LCSW
• Gregory B Canney, DMD
• Daniel Castiglia, R.PH.

• Independent Duty Medical Technicians in McGuire AFB, NJ
• Providers in McGuire AFB, 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 Oct 26, 2010; 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.