BRANCH MEDICAL CLINIC BANCROFT HALL (NPI# 1033315080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033315080 |
| Entity Type | Organization |
| Organization Name | BRANCH MEDICAL CLINIC BANCROFT HALL |
| Practice Address |
121 Blake Rd Annapolis MD 21402-1300 |
| Mailing Address |
8901 Wisconsin Ave Psc Box 509 Code 6300 Bethesda MD 20889-0001 |
| Practice Telephone | 4102931771 |
| Mailing Telephone | 3012954934 |
| Mailing Fax Number | 3012951299 |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2017-12-19 |
| Authorized Official Name | MR. WILLIAM MICHAEL CONDON (NAVY MEDICINE UBO PROGRAM MANAGER) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HEALTH CLINIC ANNAPOLIS |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| Street Address |
121 BLAKE RD |
| City | ANNAPOLIS |
| State | MD |
| Zip Code | 21402-1300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154793503 | Meghan C. Melinchak | Specialist/Technologist | 121 Blake Rd, Annapolis, MD 21402-1300 | 2015-10-26 |
| 1104197466 | Jared Kartchner Heal | Emergency Medicine | 121 Blake Rd, Annapolis, MD 21402-1300 | 2012-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427404656 | Karen Ruth Taylor | Social Worker | Usna - Midshipmen Development Center, Bancroft Hall 8m38a, Annapolis, MD 21402 | 2016-05-06 |
| 1710974902 | Ruben Del Pilar | Family Medicine | Naval Health Clinic Annapolis, 250 Wood Road, Annapolis, MD 21402 | 2005-10-03 |
| 1891789137 | Raymond Donald Chronister | Specialist/Technologist | Physical Education, Field House, U. S. Naval Academy, Annapolis, MD 21402 | 2005-09-01 |
| 1649682162 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 695 Kinkaid Rd, Naval Health Clinic Annapolis, Annapolis, MD 21402 | 2014-06-02 |
| 1619303484 | Melanie Cooper Carmody | Pharmacist | 250 Wood Road, Nhc Annapolis, Annapolis, MD 21402 | 2013-09-24 |
| 1770599060 | Collette Stevenson | Dental Hygienist | 250 Wood Road, Naval Health Clinic, Annapolis, MD 21402 | 2006-07-31 |
| 1447272505 | Michelle M. Decker | Dental Hygienist | 250 Wood Road, Naval Health Clinic, Annapolis, MD 21402 | 2006-07-24 |
| 1851313936 | Eunice Smith | Dental Hygienist | 250 Wood Road, Naval Health Clinic, Annapolis, MD 21402 | 2006-07-24 |
| 1316229701 | Shields Vision | Optometrist | 321 Kinkaid Rd, Building 329, Annapolis, MD 21402-1002 | 2011-09-13 |
| 1124259718 | Anchor Eyecare Annapolis | Optometrist | 321 Kinkaid Rd, Building 329, Annapolis, MD 21402-1002 | 2009-07-31 |
| Find all providers in zip 21402 | ||||
| Taxonomy Code | 261QM1100X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military/U.S. Coast Guard Outpatient |
| The Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: title modified, definition added; 7/1/2006 title modified, definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528013414 | Naval Health Clinic Annapolis | Clinic/Center | 250 Wood Rd, Annapolis, MD 21402-1257 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841498417 | Branch Medical Clinic Indian Head | Clinic/Center | 4141 W Wilson Rd, Suite105, Indian Head, MD 20640-5162 | 2007-07-05 |
| 1063959450 | Uscg Clinic Baltimore | Clinic/Center | 2401 Hawkins Point Rd, Curtis Bay, MD 21226-1797 | 2017-01-24 |
| 1043668775 | Logistics Health Incorporated | Clinic/Center | 4201 Northview Dr Ste 410, Bowie, MD 20716-2668 | 2016-06-03 |
| 1811228422 | Us Coast Guard | Clinic/Center | 2401 Hawkins Point Rd, Baltimore, MD 21226-1797 | 2010-01-21 |
| 1851622401 | Us Coast Guard Yard - Hswl Clinic | Clinic/Center | 2401 Hawkins Point Rd, Bldg 28b, Baltimore, MD 21226 | 2010-01-21 |
| 1487850541 | Branch Medical Clinic Andrews | Clinic/Center | 1 San Diego Loop, Bldg 3282, Andrews Afb, MD 20762-5518 | 2007-06-26 |
| 1316142607 | Kimbrough Acc Military Mtf | Clinic/Center | 1434 Porter St, Usadc, Fort Detrick, MD 21702-9210 | 2007-06-18 |
| 1093910374 | Kimbrough Acc Military Mtf | Clinic/Center | 4110 Austin Road, Aberdeen Proving Ground, MD 21010 | 2007-06-18 |
| 1689879926 | Kimbrough Acc Military Mtf | Clinic/Center | 2501 Oakington St, Aberdeen Proving Ground, MD 21005-5131 | 2007-06-18 |
| 1124223797 | Kimbrough Acc Military Mtf | Clinic/Center | 8472 Simmond St, Fort Meade, MD 20755-5700 | 2007-06-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.