LAVON JOHNSON IDMT
NPI 1962828806
Military Health Care Provider - Independent Duty Medical Technicians in Nellis Afb, NV

Active since March 17, 2014
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-2273 Get Directions Write a Review

NPPES record last updated: May 3, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Lavon Johnson Idmt NPPES

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

LAVON JOHNSON IDMT (NPI 1962828806) is an individual independent duty medical technicians provider in Nellis Afb, Nevada and active in the NPI registry since March 2014.

NPPES Registry Identity

NPI1962828806
Entity TypeIndividualMale
Primary Taxonomy1710I1003X
Provider Legal NameLAVON JOHNSONCredential: IDMT
Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6600
Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6600 · (702) 653-2273
Sole ProprietorNo
Enumeration DateMarch 17, 2014
Last NPPES UpdateMay 3, 2022
NPPES CertifiedMay 3, 2022
NPI 1962828806 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.

4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191

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.

Family Medicine
4700 LAS VEGAS BLVD N, NELLIS AFB
LAS VEGAS, NV 89191
Psychiatry & Neurology (Psychiatry)
4700 LAS VEGAS BLVD N, MIKE O'CALLAGHAN FEDERAL HOSPITAL
NELLIS AFB, NV 89191
Orthopaedic Surgery
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Physician Assistant (Medical)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Podiatrist (Foot & Ankle Surgery)
4700 LAS VEGAS BLVD N
NELLIS AFB, NV 89191
Advanced Practice Midwife
4700 LAS VEGAS BLVD N
LAS VEGAS, NV 89191
Advanced Practice Midwife
4700 LAS VEGAS BLVD N, 99 MSGS/SGCG
NELLIS AFB, NV 89191
Dentist (General Practice)
4700 LAS VEGAS BLVD N, MIKE O'CALLAGHAN FEDERAL HOSPITAL
NELLIS AFB, NV 89191

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1962828806, enumerated as an "individual" on March 17, 2014.

The provider is located at 4700 LAS VEGAS BLVD N NELLIS AFB, NV 89191 and the phone number is (702) 653-2273.

Military Health Care Provider with taxonomy code 1710I1003X and a focus in Independent Duty Medical Technicians.