Adam Dutton Redmond, IDC

Key facts

NPI

1831471119

Entity type

Individual (NPI type 1)

Primary specialty

Independent Duty Corpsman 1710I1002X

Practice address

4346 Augusta Road
Lexington, CA 29073

Phone

(803) 315-6316

NPI assigned

Sep 13, 2011

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 13, 2011.

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315872000000",
    "number": "1831471119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4346 AUGUSTA ROAD",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "29073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4346 AUGUSTA ROAD",
            "city": "LEXINGTON",
            "state": "CA",
            "postal_code": "29073",
            "telephone_number": "803-315-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REDMOND",
        "first_name": "ADAM",
        "middle_name": "DUTTON",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}