WOMACK ARMY MEDICAL CENTER (NPI# 1154526275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154526275 |
| Entity Type | Organization |
| Organization Name | WOMACK ARMY MEDICAL CENTER |
| Other Organization Name | USADC FT. BRAGG ONE STOP |
| Practice Address |
3718 Gruber Rd Usadc One Stop Fort Bragg NC 28310-8934 |
| Mailing Address |
2817 Reilly St Mcxc-dbo-ub Wamc Stop A Fort Bragg NC 28310-7324 |
| Practice Telephone | 9102965012 |
| Mailing Telephone | 9109076693 |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2013-02-11 |
| Authorized Official Name | BARBARA BLACK (UBO MANAGER) |
| Authorized Official Telephone | 9109078537 |
| Is Organization Subpart | Y |
| Parent Organization Name | WOMACK ARMY MEDICAL CENTER |
| 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 FT. BRAGG ONE STOP | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356907471 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 4-2817 Reilly Rd Bldg B, Fort Bragg, NC 28310-0001 | 2019-05-14 |
| 1891246708 | Womack Army Medical Center | Pharmacy | 1571 Reilly Rd, Bldg 4, Ft Bragg, NC 28307 | 2016-10-17 |
| 1861867293 | Womack Army Medical Center | Military Hospital | 2817 Reily Road, Fort Bragg, NC 28317 | 2015-12-10 |
| 1700250248 | Womack Army Medical Center | Rehabilitation Unit | 215 Ice Ave, 100, Dayton, OH 45402 | 2015-11-20 |
| 1205206935 | Womack Army Medical Center | Clinic/Center | 3908 Longstreet, Bldg 3-4303, Fort Bragg, NC 28310-0001 | 2015-10-07 |
| 1932577368 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 55 Centennial Pkwy, Cameron, NC 28326-4013 | 2015-09-02 |
| 1578951042 | Womack Army Medical Center | Clinic/Center | 55 Centennial Parkway, Cameron, NC 28326 | 2015-01-06 |
| 1801215660 | Womack Army Medical Center | Clinic/Center | 2857 Watson St, Bldg M-1704, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1710306576 | Womack Army Medical Center | Clinic/Center | Tagaytay Rd Bldg C-1624, Fort Bragg, NC 28310-7301 | 2014-04-09 |
| 1508285362 | Womack Army Medical Center | Clinic/Center | Kendenburg St Bldg H-6338, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| Street Address |
3718 GRUBER RD USADC ONE STOP |
| City | FORT BRAGG |
| State | NC |
| Zip Code | 28310-8934 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447455936 | Womack Army Medical Center | Clinic/Center | 3718 Gruber Rd, Fort Bragg, NC 28310-8934 | 2007-06-15 |
| 1326490624 | Markisha Long | Dental Hygienist | 3718 Gruber Rd, Fort Bragg, NC 28310-8934 | 2016-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013550763 | Brent Francis Bachman | Physician Assistant | 2817 Reilly Street, Fort Bragg, NC 28310 | 2019-10-25 |
| 1417503459 | Cooper Pasque | Dentist | 1838 Normandy Dr., Fort Bragg, Apo, AA 28310 | 2019-08-15 |
| 1851959951 | Daniel Jordan Whitaker | Student in an Organized Health Care Education/Training Program | Womack Army Medical Center, 2817 Reilly Road, Mcxc-cod Credentials, Fort Bragg, NC 28310 | 2019-06-03 |
| 1679054217 | Christopher Cetnar | Dentist | Smokebomb Hill, Bldg 3718 Gruber Road, Fort Bragg, NC 28310 | 2018-08-22 |
| 1316427107 | Alexandrea Lee Clark | Dentist | Laflamme Dental Clinic, Bldg C6238 Ardennes Road, Fort Bragg, NC 28310 | 2018-08-21 |
| 1457843831 | Kevin Patrick Hudson | Student in an Organized Health Care Education/Training Program | 2817 Reilly Road Mxcx - Cod Credentials, Womack Army Medical Center, Fort Bragg, NC 28310 | 2018-06-01 |
| 1639691462 | Margaret S Greene | Dentist | Usa Dental Health Activity Fort Bragg, Wamc Box #151 2817 Rielly Rd, Fort Bragg, NC 28310 | 2017-07-13 |
| 1912432246 | Chezdan Baker | Student in an Organized Health Care Education/Training Program | Us Army Dental Health Activity Bldg-6837 Normandy Drive, Fort Bragg, NC 28310 | 2017-04-24 |
| 1215483094 | Shantryce Monique Boatwright Crump | Dental Hygienist | 2617 Rielly Road, Fort Bragg, NC 28310 | 2016-08-31 |
| 1629435714 | John Gagnier | Physician Assistant | Gruber Road, Building #c-1722, Fort Bragg, NC 28310 | 2016-01-21 |
| Find all providers in zip 28310 | ||||
| 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 |
|---|---|---|---|---|
| 1205206935 | Womack Army Medical Center | Clinic/Center | 3908 Longstreet, Bldg 3-4303, Fort Bragg, NC 28310-0001 | 2015-10-07 |
| 1801215660 | Womack Army Medical Center | Clinic/Center | 2857 Watson St, Bldg M-1704, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1710306576 | Womack Army Medical Center | Clinic/Center | Tagaytay Rd Bldg C-1624, Fort Bragg, NC 28310-7301 | 2014-04-09 |
| 1508285362 | Womack Army Medical Center | Clinic/Center | Kendenburg St Bldg H-6338, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1649476987 | Womack Army Medical Center | Clinic/Center | 4-1838 Normandy Dr, Fort Bragg, NC 28310-0001 | 2007-06-25 |
| 1427253541 | Womack Army Medical Center | Clinic/Center | 4861 Logistic Ave, Fort Bragg, NC 28310-0001 | 2007-06-19 |
| 1447455936 | Womack Army Medical Center | Clinic/Center | 3718 Gruber Rd, Fort Bragg, NC 28310-8934 | 2007-06-15 |
| 1194920678 | Womack Army Medical Center | Clinic/Center | 3836 Ardennes St, Fort Bragg, NC 28310-8922 | 2007-06-15 |
| 1306041884 | Womack Army Medical Center | Clinic/Center | 6238 Ardennes Rd, Fort Bragg, NC 28310-0001 | 2007-06-15 |
| 1295941664 | Womack Army Medical Center | Clinic/Center | 44 Bastogne Dr, Fort Bragg, NC 28310-0001 | 2007-05-15 |
| Find all providers in FORT BRAGG | ||||
| City | FORT BRAGG |
| Zip Code | 28310 |
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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.