Angie Cain, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

633 Medical Group
77 Neally Ave
Joint Base Langley-Eustis, VA 23665-2040

Phone

(757) 764-2109

NPI assigned

May 1, 2009

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": "1241136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294704000000",
    "number": "1669606802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 MEDICAL GROUP",
            "address_2": "77 NEALLY AVE",
            "city": "JOINT BASE LANGLEY-EUSTIS",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "757-764-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 MEDICAL GROUP",
            "address_2": "77 NEALLY AVE",
            "city": "JOINT BASE LANGLEY-EUSTIS",
            "state": "VA",
            "postal_code": "236652040",
            "telephone_number": "757-764-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAIN",
        "first_name": "ANGIE",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-01",
        "last_updated": "2011-01-11",
        "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": []
}

• Adam Labree Bourgon, DO
• William E Brooks, MD
• Peter Bradley Broughton, MD
• Andrew Michael Bruton, M.D.
• Adam Buffington, PH.D.
• Patricia E. Cash-Parkerson, CRNA
• Lynnette Cipolla, RDH
• Tracy Conder, RD, CSSD
• Joseph Desilets
• Keith Duron, CRDH

• All providers in Joint Base Langley-Eustis, VA
• Independent Duty Medical Technicians in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.