KELLER ARMY COMMUNITY HOSPITAL (NPI# 1124223235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124223235 |
| Entity Type | Organization |
| Organization Name | KELLER ARMY COMMUNITY HOSPITAL |
| Other Organization Name | USADC WEST POINT MILLS |
| Practice Address |
5660 Doughboy Loop Fort Dix NJ 08640 |
| Mailing Address |
900 Washington Rd Attn Mcud-rmd-ubo West Point NY 10996-1109 |
| Practice Telephone | 8459384034 |
| Mailing Telephone | 8459388239 |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2012-12-20 |
| Authorized Official Name | KENNETH TUFFY (UBO MANAGER) |
| Authorized Official Telephone | 8459388239 |
| Is Organization Subpart | Y |
| Parent Organization Name | KELLER 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 |
| Other Name | Type Code |
|---|---|
| USADC WEST POINT MILLS | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235334392 | Keller Army Community Hospital | Clinic/Center | 606 Cullum Road, Building 606, West Point, NY 10996 | 2007-06-19 |
| 1275747149 | Keller Army Community Hospital | Clinic/Center | 5631 Baltimore St, Fort Dix, NJ 08640-5440 | 2007-05-10 |
| 1174622542 | Keller Army Community Hospital | Pharmacy | Bldg 606, West Point, NY 10996 | 2006-09-22 |
| 1427157882 | Keller Army Community Hospital | Pharmacy | Bldg 900, West Point, NY 10996 | 2006-09-22 |
| 1912006362 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 114 Rm 175, Ft Hamilton, NY 11252 | 2006-09-22 |
| 1588763841 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 11 Hap Amold Blvd, Tobyhanna, PA 18466 | 2006-09-22 |
| 1528167970 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 18th St and Doughboy Loop Bldg 5660, Troop Medical Health Clinic, Ft Dix, NJ 08640 | 2006-09-22 |
| 1912006685 | Keller Army Community Hospital | Clinic/Center | Bldg. 1075 Stephenson Ave., Ft. Monmouth, NJ 07703 | 2006-09-21 |
| 1861469355 | Keller Army Community Hospital | Rehabilitation Unit | 11 Hap Arnold Blvd, Health Clinic, Tobyhanna, PA 18466-5002 | 2006-03-02 |
| 1861898942 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 114 White Ave, Brooklyn, NY 11252-9503 | 2014-11-17 |
| Street Address |
5660 DOUGHBOY LOOP |
| City | FORT DIX |
| State | NJ |
| Zip Code | 08640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407918022 | James Richard Ross | Dentist | 5660 Doughboy Loop, Mills Dental Clinic, Fort Dix, NJ 08640 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841428174 | Joseph Nunzio Coyle | Military Health Care Provider | 5651 Texas Ave., Fort Dix, NJ 08640 | 2009-06-25 |
| 1114128832 | Philadelphia Va Medical Center | Clinic/Center | 8th and Alabama St, Building 5437, Fort Dix, NJ 08640 | 2007-05-30 |
| 1467653501 | Scott J Winters | Registered Nurse | United States Army, Walson Army Hospital, Ft Dix, NJ 08640 | 2007-05-29 |
| 1700091147 | Kenneth Harry Schmidt | Pharmacist | 5756 Hartford Road, Fort Dix, NJ 08640 | 2007-05-11 |
| 1669692943 | Robert Antonio Cabanas | Dentist | 5755 Hartford Rd, Fci Fort Dix, Fort Dix, NJ 08640 | 2007-04-27 |
| 1063569556 | Erwin Hillard Goldrich | Dentist | 5660 Doughboy Ave, Fort Dix, NJ 08640 | 2007-01-05 |
| 1235212358 | John Joseph Sweeney IIi | Internal Medicine | Eighth and Alabama, Outpatient Clinic At Marshall Hall, Fort Stdix, NJ 08640 | 2006-10-23 |
| 1154421196 | Anthony Louis Capone | Social Worker | 8th Streeet Building 5437, Fort Dix, NJ 08640 | 2006-09-22 |
| 1528167970 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 18th St and Doughboy Loop Bldg 5660, Troop Medical Health Clinic, Ft Dix, NJ 08640 | 2006-09-22 |
| 1215041785 | Janis Marie Davidson | Nurse Practitioner | 5438 8th Street, Fort Dix, NJ 08640 | 2006-08-19 |
| Find all providers in zip 08640 | ||||
| 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 |
|---|---|---|---|---|
| 1275747149 | Keller Army Community Hospital | Clinic/Center | 5631 Baltimore St, Fort Dix, NJ 08640-5440 | 2007-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962660340 | United States Coast Guard, Air Station Atlantic City | Clinic/Center | Faa Tech Center Bldg 350, Uscg Medical Dept, Pomona, NJ 08405 | 2008-06-02 |
| 1952509812 | Branch Medical Clinic Lakehurst | Clinic/Center | Bldg 39 Landsdowne Road, Lakehurst, NJ 08733-5006 | 2007-07-03 |
| 1912006685 | Keller Army Community Hospital | Clinic/Center | Bldg. 1075 Stephenson Ave., Ft. Monmouth, NJ 07703 | 2006-09-21 |
| 1528245271 | Uscg Clinic Cape May | Clinic/Center | 1 Munro Ave, Health Services Division, Cape May, NJ 08204-5000 | 2008-01-24 |
| 1477750990 | Branch Medical Clinic Earle | Clinic/Center | 201 State Route 34 S, Colts Neck, NJ 07722-1902 | 2007-06-28 |
| 1205031770 | Keller Army Community Hospital | Clinic/Center | 1075 Stephenson Ave, Usadc, Fort Monmouth, NJ 07703-1518 | 2007-06-15 |
| 1972667228 | Uscg Samuel J Call Health Services | Clinic/Center | 1 Munro Ave, Cape May, NJ 08204-5000 | 2006-12-21 |
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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.