BAYNE-JONES ARMY COMMUNITY HOSPITAL (NPI# 1093129124) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1093129124 |
Entity Type | Organization |
Organization Name | BAYNE-JONES ARMY COMMUNITY HOSPITAL |
Other Organization Name | 10TH MTN BCT CLINIC-POLK |
Practice Address |
2040 Dragoon Loop Bldg 1170 Fort Polk LA 71459-5242 |
Mailing Address |
1585 3rd St Bldg 285 Fort Polk LA 71459-5102 |
Practice Telephone | 3375313118 |
Mailing Telephone | 3375313482 |
Enumeration Date | 2014-06-17 |
Last Update Date | 2015-04-08 |
Authorized Official Name | CAROLYN JONES (UBO) |
Authorized Official Telephone | 3376533220 |
Is Organization Subpart | Y |
Parent Organization Name | BAYNE-JONES ARMY COMMUNITY HOSPITAL |
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 |
State | Issuer | Identifier | Type Code |
---|---|---|---|
PARENT BJACH NPI 2 | 1104991215 | 01 |
Other Name | Type Code |
---|---|
10TH MTN BCT CLINIC-POLK | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669815429 | Bayne-jones Army Community Hospital | Clinic/Center | 8103 Georgia Avenue, Bldg 3516, Ft Polk, LA 71459 | 2013-04-11 |
1710224514 | Bayne-jones Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 8091 Georgia Ave Bldg 3504, Fort Polk, LA 71459-5468 | 2013-01-14 |
1578891222 | Bayne-jones Army Community Hospital | Clinic/Center | 8097 Georgia Ave, Bldg 3507, Ft Polk, LA 71459 | 2009-11-18 |
1619172905 | Bayne-jones Army Community Hospital | Clinic/Center | 1561 Mississippi Street, Fort Polk, LA 71459 | 2007-06-18 |
1033218441 | Bayne-jones Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 1585 3rd St, Bayne Jones Army Community Hosp, Ft Polk, LA 71459 | 2006-09-22 |
1841547650 | Bayne-jones Army Community Hospital | Clinic/Center | 8091 Georgia Ave, Bld 3504 Ctmc, Fort Polk, LA 71459-5468 | 2012-08-10 |
1609024504 | Bayne-jones Army Community Hospital | Clinic/Center | 1585 3rd St, Chesser Dental Clinic, Fort Polk, LA 71459-5102 | 2008-09-04 |
1811192461 | Bayne-jones Army Community Hospital | Clinic/Center | 1585 3rd St, Building 285, Fort Polk, LA 71459-5102 | 2007-06-15 |
1104991215 | Bayne-jones Army Community Hospital | Clinic/Center | 1585 Third Street, Fort Polk, LA 71459-6000 | 2006-11-22 |
Street Address |
2040 DRAGOON LOOP BLDG 1170 |
City | FORT POLK |
State | LA |
Zip Code | 71459-5242 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1952806986 | Brenda Moore | Dental Hygienist | 7223 Mississippi Ave Building 2157, Fort Polk, LA 71459 | 2018-03-30 |
1073017158 | Tiffany Alexander | Dental Assistant | 1561 Mississippi Ave, Ft Polk, LA 71459 | 2018-03-22 |
1922524529 | Keith Allan Smiley | Dentist | 7223 Mississippi Avenue Bldg. 1561, Fort Polk, LA 71459 | 2017-08-16 |
1336663046 | Alexis Caitlyn Stamm | Specialist/Technologist | 5644 Bazydlo Ct, Fort Polk, LA 71459 | 2017-08-03 |
1538615893 | Remedios Macan Dondoyano | Physical Therapist | Bayne-jones Army Community Hospital, 1585 3rd St., Attn: Pt Department, Fort Polk, LA 71459 | 2016-08-28 |
1306298997 | Roslyn Faulk | Dental Assistant | 7223 Mississippi Avenut, Frot Polk, LA 71459 | 2016-07-07 |
1346691888 | Joy Martin | Dental Hygienist | 7223 Mississippi Avenue, Fort Polk, LA 71459 | 2016-06-27 |
1255743936 | Aprille Boudreau | Counselor | 5513 B Gardner Dr., Fort Polk, LA 71459 | 2014-05-29 |
1407273170 | Mikaela Diana Mcmanus | Physician Assistant | Building 7318 C Ave G, Fort Polk, LA 71459 | 2014-03-19 |
1669815429 | Bayne-jones Army Community Hospital | Clinic/Center | 8103 Georgia Avenue, Bldg 3516, Ft Polk, LA 71459 | 2013-04-11 |
Find all providers in zip 71459 |
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 |
---|---|---|---|---|
1619172905 | Bayne-jones Army Community Hospital | Clinic/Center | 1561 Mississippi Street, Fort Polk, LA 71459 | 2007-06-18 |
1841547650 | Bayne-jones Army Community Hospital | Clinic/Center | 8091 Georgia Ave, Bld 3504 Ctmc, Fort Polk, LA 71459-5468 | 2012-08-10 |
1609024504 | Bayne-jones Army Community Hospital | Clinic/Center | 1585 3rd St, Chesser Dental Clinic, Fort Polk, LA 71459-5102 | 2008-09-04 |
1811192461 | Bayne-jones Army Community Hospital | Clinic/Center | 1585 3rd St, Building 285, Fort Polk, LA 71459-5102 | 2007-06-15 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669815429 | Bayne-jones Army Community Hospital | Clinic/Center | 8103 Georgia Avenue, Bldg 3516, Ft Polk, LA 71459 | 2013-04-11 |
1578891222 | Bayne-jones Army Community Hospital | Clinic/Center | 8097 Georgia Ave, Bldg 3507, Ft Polk, LA 71459 | 2009-11-18 |
1053598557 | Coast Guard Isc Nola | Clinic/Center | 1790 Saturn Road, New Orleans, LA 70129-2218 | 2008-01-28 |
1780742049 | Base New Orleans Clinic | Clinic/Center | 1790 Saturn St, Uscg Base Nola Medical Clinic, New Orleans, LA 70129-2270 | 2006-12-05 |
1538123435 | Naval Ambulatory Care Center | Clinic/Center | 2300 General Meyer Ave., Bldg H100, New Orleans, LA 70142-0001 | 2006-04-17 |
1396046462 | Hswl Neworleans | Clinic/Center | 1790 Saturn St, New Orleans, LA 70129-2270 | 2010-11-05 |
1629278064 | Branch Medical Clinic Belle Chasse | Clinic/Center | 400 Russell Ave, Bldg 41, New Orleans, LA 70143-5077 | 2007-07-24 |
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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.