IVAN VICENTE IDMT
NPI 1710201553
Military Health Care Provider - Independent Duty Medical Technicians in Ellsworth Afb, SD

Active since March 23, 2010
433 BLACK ELK CT, ELLSWORTH AFB, SD 57706(605) 521-3502 Get Directions Write a Review

NPPES record last updated: March 23, 2010. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ivan Vicente Idmt NPPES

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

IVAN VICENTE IDMT (NPI 1710201553) is an individual independent duty medical technicians provider in Ellsworth Afb, South Dakota and active in the NPI registry since March 2010.

NPPES Registry Identity

NPI1710201553
Entity TypeIndividualMale
Primary Taxonomy1710I1003X
Provider Legal NameIVAN VICENTECredential: IDMT
Location Address433 BLACK ELK CTEllsworth Afb, SD 57706-1847
Mailing Address433 Black Elk CtEllsworth Afb, SD 57706-1847 · (605) 521-3502
Sole ProprietorNo
Enumeration DateMarch 23, 2010
NPI 1710201553 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.
433 BLACK ELK CT, Ellsworth Afb, SD 57706

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 Ivan Vicente's NPI number?

The NPI number for Ivan Vicente is 1710201553. It was assigned to this individual provider in the NPPES registry on March 23, 2010.

Where is Ivan Vicente located?

Ivan Vicente practices at 433 Black Elk Ct, Ellsworth Afb, SD 57706. The listed phone number is (605) 521-3502.

What is Ivan Vicente'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 Ivan Vicente was last updated on March 23, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.