MIKE O'CALLAGHAN MILITARY MEDICAL CENTER
NPI 1902787500
Military Health Care Provider - Independent Duty Medical Technicians in Nellis Afb, NV

Active since September 10, 2025
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-2273 Get Directions Write a Review

NPPES record last updated: September 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mike O'callaghan Military Medical Center NPPES

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

MIKE O'CALLAGHAN MILITARY MEDICAL CENTER (NPI 1902787500) is a healthcare organization registered as an independent duty medical technicians in Nellis Afb, Nevada and active in the NPI registry since September 2025. The organization lists Ross K Konicke, Idmt, as its authorized official.

NPPES Registry Identity

NPI1902787500
Entity TypeOrganization
Primary Taxonomy1710I1003X
Legal Business NameMIKE O'CALLAGHAN MILITARY MEDICAL CENTER
Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6600
Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6600 · (702) 653-2273
Organization SubpartNo
Authorized OfficialRoss K KonickeIdmt · (702) 653-2273
Enumeration DateSeptember 10, 2025
NPPES CertifiedSeptember 10, 2025
NPI 1902787500 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.

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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.

Integrative Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Physical Therapist (Orthopedic)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Obstetrics & Gynecology
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Psychiatry & Neurology (Neurology)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Emergency Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Pharmacist
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Internal Medicine
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191

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 Mike O'callaghan Military Medical Center's NPI number?

The NPI number for Mike O'callaghan Military Medical Center is 1902787500. It was assigned to this organization in the NPPES registry on September 10, 2025.

Where is Mike O'callaghan Military Medical Center located?

Mike O'callaghan Military Medical Center is located at 4700 Las Vegas Blvd N, Nellis Afb, NV 89191. The listed phone number is (702) 653-2273.

What is Mike O'callaghan Military Medical Center'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 Mike O'callaghan Military Medical Center was last updated on September 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.