Individual provider Active NPI

Michael Brian Sexton, IDC MILITARY

  • Independent Duty Corpsman
  • Pearl Harbor, HI
National Provider Identifier
1831124007
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty CorpsmanTaxonomy code 1710I1002X
Practice address
Fpo Ap 96662-2418
Uss Columbus SSN 762
Pearl Harbor, HI 96860
Phone
(360) 720-1096
NPI assigned
Jul 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Corpsman 1710I1002X CT Primary

Addresses

Primary practice location

Fpo Ap 96662-2418
Uss Columbus SSN 762
Pearl Harbor, HI 96860

Mailing address

20 Ellis St
Freehold, NJ 07728-1810
Phone (360) 720-1096

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": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831124007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 ELLIS ST",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077281810",
            "telephone_number": "360-720-1096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FPO AP 96662-2418",
            "address_2": "USS COLUMBUS SSN 762",
            "city": "PEARL HARBOR",
            "state": "HI",
            "postal_code": "96860",
            "telephone_number": "360-720-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEXTON",
        "first_name": "MICHAEL",
        "middle_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "IDC MILITARY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl Harbor, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.