RAQUEL SHELLY SOLIVAN WILSON IDMT
NPI 1528379732
Military Health Care Provider - Independent Duty Medical Technicians in Moody Afb, GA

Active since June 23, 2010
23 MEDICAL GROUP/SGPF 3278 MITCHELL BLVD BLD 900, MOODY AFB, GA 31699(229) 257-4685(229) 257-3242 Get Directions Write a Review

NPPES record last updated: November 8, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Nov 8, 2023, Apr 30, 2018 (2 updates tracked since 2018).

About Raquel Shelly Solivan Wilson Idmt NPPES

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

RAQUEL SHELLY SOLIVAN WILSON IDMT (NPI 1528379732) is an individual independent duty medical technicians provider in Moody Afb, Georgia and active in the NPI registry since June 2010.

NPPES Registry Identity

NPI1528379732
Entity TypeIndividualFemale
Primary Taxonomy1710I1003X
Provider Legal NameRAQUEL SHELLY SOLIVAN WILSONCredential: IDMT
Location Address23 MEDICAL GROUP/SGPF 3278 MITCHELL BLVD BLD 900Moody Afb, GA 31699-8273
Mailing Address23 Medical Group/sgpf 3278 Mitchell Blvd Bldg 900Moody Afb, GA 31699-0001 · (229) 257-4685 · Fax (229) 257-3242
Fax(229) 257-3242
Sole ProprietorNo
Enumeration DateJune 23, 2010
Last NPPES UpdateNovember 8, 20232 updates tracked since enumeration
NPPES CertifiedNovember 8, 2023
NPI 1528379732 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.
23 MEDICAL GROUP/SGPF 3278 MITCHELL BLVD BLD 900, Moody Afb, GA 31699

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 Raquel Solivan Wilson's NPI number?

The NPI number for Raquel Solivan Wilson is 1528379732. It was assigned to this individual provider in the NPPES registry on June 23, 2010.

Where is Raquel Solivan Wilson located?

Raquel Solivan Wilson practices at 23 Medical Group/Sgpf 3278 Mitchell Blvd Bld 900, Moody Afb, GA 31699. The listed phone number is (229) 257-4685.

What is Raquel Solivan Wilson'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 Raquel Solivan Wilson was last updated on November 8, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.