BOB KEOPHAKDY IDMT
NPI 1124797410
Military Health Care Provider - Independent Duty Medical Technicians in Charleston, SC

Active since September 09, 2021
204 W HILL BLVD, CHARLESTON, SC 29404(843) 963-6880 Get Directions Write a Review

NPPES record last updated: December 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 3, 2025, Sep 9, 2021 (2 updates tracked since 2021).

About Bob Keophakdy Idmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BOB KEOPHAKDY IDMT (NPI 1124797410) is an individual independent duty medical technicians provider in Charleston, South Carolina and active in the NPI registry since September 2021. He maintains a secondary practice location in Apo.

NPPES Registry Identity

NPI1124797410
Entity TypeIndividualMale
Primary Taxonomy1710I1003X
Provider Legal NameBOB KEOPHAKDYCredential: IDMT
Location Address204 W HILL BLVDCharleston, SC 29404-4704
Mailing AddressPsc 62 Box 7002Apo, AE 09643-0071 · (314) 722-8069
Sole ProprietorNo
Enumeration DateSeptember 9, 2021
Last NPPES UpdateDecember 3, 20252 updates tracked since enumeration
NPPES CertifiedDecember 3, 2025
NPI 1124797410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code1710I1003X
Definition
An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
204 W HILL BLVD, Charleston, SC 29404

Secondary Practice Location 1

Location 1PSC 62 Box 7002APO, AE 09643-0071 · Phone (314) 722-8069

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Clinic/Center
204 W HILL BLVD
CHARLESTON AFB, SC 29404
Social Worker (Clinical)
204 W HILL BLVD
CHARLESTON AFB, SC 29404
Family Medicine
204 W HILL BLVD
CHARLESTON AFB, SC 29404
Pharmacist
204 W HILL BLVD, 628TH MEDICAL GROUP
CHARLESTON AFB, SC 29404
Military Health Care Provider (Independent Duty Medical Technicians)
204 W HILL BLVD
CHARLESTON AFB, SC 29404
Social Worker (Clinical)
204 W HILL BLVD
JOINT BASE CHARLESTON, SC 29404
Social Worker (Clinical)
204 W HILL BLVD
JOINT BASE CHARLESTON, SC 29404
Preventive Medicine (Aerospace Medicine)
204 W HILL BLVD
CHARLESTON AFB, SC 29404

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bob Keophakdy's NPI number?

The NPI number for Bob Keophakdy is 1124797410. It was assigned to this individual provider in the NPPES registry on September 9, 2021.

Where is Bob Keophakdy located?

Bob Keophakdy practices at 204 W Hill Blvd, Charleston, SC 29404. The listed phone number is (843) 963-6880.

What is Bob Keophakdy's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Medical Technicians, with taxonomy code 1710I1003X.

When was this NPI record last updated?

The NPPES record for Bob Keophakdy was last updated on December 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.