NICOLE PENNOCK IDMT
NPI 1508000225
Military Health Care Provider - Independent Duty Medical Technicians in Mcguire Afb, NJ

Active since April 24, 2009
3458 NEELY RD, MCGUIRE AFB, NJ 08641(609) 754-9080 Get Directions Write a Review

NPPES record last updated: April 24, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Nicole Pennock Idmt NPPES

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

NICOLE PENNOCK IDMT (NPI 1508000225) is an individual independent duty medical technicians provider in Mcguire Afb, New Jersey and active in the NPI registry since April 2009.

NPPES Registry Identity

NPI1508000225
Entity TypeIndividualFemale
Primary Taxonomy1710I1003X
Provider Legal NameNICOLE PENNOCKCredential: IDMT
Location Address3458 NEELY RDMcguire Afb, NJ 08641
Mailing Address3458 Neely RdMcguire Afb, NJ 08641
Sole ProprietorNo
Enumeration DateApril 24, 2009
NPI 1508000225 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.
3458 NEELY RD, Mcguire Afb, NJ 08641

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.

Dietitian, Registered
3458 NEELY RD
MC GUIRE AFB, NJ 08641
Dentist (General Practice)
3458 NEELY RD
JB MDL, NJ 08641
Social Worker (Clinical)
3458 NEELY RD
MC GUIRE AFB, NJ 08641
Social Worker
3458 NEELY RD
JB MDL, NJ 08641
Nurse Practitioner (Psychiatric/Mental Health)
3458 NEELY RD
JB MDL, NJ 08641
Physical Therapist
3458 NEELY RD
TRENTON, NJ 08641
Psychologist
3458 NEELY RD
TRENTON, NJ 08641
Social Worker
3458 NEELY RD
MC GUIRE AFB, NJ 08641

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 Nicole Pennock's NPI number?

The NPI number for Nicole Pennock is 1508000225. It was assigned to this individual provider in the NPPES registry on April 24, 2009.

Where is Nicole Pennock located?

Nicole Pennock practices at 3458 Neely Rd, Mcguire Afb, NJ 08641. The listed phone number is (609) 754-9080.

What is Nicole Pennock'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 Nicole Pennock was last updated on April 24, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years 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.