NAVAL MEDICAL CENTER PORTSMOUTH (NPI# 1205249075) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205249075 |
| Entity Type | Organization |
| Organization Name | NAVAL MEDICAL CENTER PORTSMOUTH |
| Practice Address |
1035 Nider Blvd Ste 100 Branch Health Clinic Virginia Beach VA 23459-8701 |
| Mailing Address |
Naval Medical Center Third Party Collections 620 John Paul Jones Cir Porthsmouth VA 23708-2111 |
| Practice Telephone | 7579538206 |
| Practice Fax Number | 7579538217 |
| Mailing Telephone | 7579538206 |
| Mailing Fax Number | 7579538217 |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2017-11-14 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL MEDICAL CENTER PORTSMOUTH |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2146178 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114403961 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 7021 Harbor View Blvd, Suffolk, VA 23435-2869 | 2018-07-16 |
| 1508270950 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1011 Eden Way N Ste H, Chesapeake, VA 23320-2768 | 2014-06-13 |
| 1205249059 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1647 Admiral Taussig Blvd Bldg Cd2, Norfolk, VA 23511-2803 | 2014-06-10 |
| 1669746822 | Naval Medical Center Portsmouth | Military Hospital | 620 John Paul Circle, Portsmouth, VA 23708 | 2012-03-05 |
| 1083782874 | Naval Medical Center Portsmouth | Military Hospital | 411 Granby St Apt 48, Norfolk, VA 23510-1935 | 2006-12-01 |
| 1609966936 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | Naval Weapons Station Yorktown, Bldg 1806, Yorktown, VA 23691-0090 | 2006-10-16 |
| 1740389865 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1185 Terrier Ave, Ste 100, Virginia Beach, VA 23461 | 2006-09-22 |
| 1861599615 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1317 Ballahack Rd Ste 100, Chesapeake, VA 23322-2499 | 2006-09-20 |
| 1891769840 | Naval Medical Center Portsmouth | Military Hospital | Naval Medical Center Posrtsmouth, 620 John Paul Jones Cir, Portsmouth, VA 23708-2197 | 2006-02-15 |
| 1366929069 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 27 Effingham St, Portsmouth, VA 23708 | 2018-07-25 |
| Street Address |
1035 NIDER BLVD STE 100 BRANCH HEALTH CLINIC |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23459-8701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205814878 | Sandra Su | Optometrist | 1035 Nider Blvd Ste 100, Virginia Beach, VA 23459-8701 | 2006-01-04 |
| 1841636750 | Thomas Blake Van Brunt Jr. | Family Medicine | 1035 Nider Blvd Ste 100, Virginia Beach, VA 23459-8701 | 2013-05-18 |
| 1598939316 | Denise L Singleton | Nurse Practitioner | 1035 Nider Blvd Ste 100, Virginia Beach, VA 23459-8701 | 2008-04-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497218556 | Carli Michelle Deitel | Student in an Organized Health Care Education/Training Program | Uss Carter Hall, Virginia Beach, VA 23459 | 2019-04-07 |
| 1508395021 | Graham Christian Ellis | Internal Medicine | Eod Esu2 Medical Department, 2520 Midway Rd, Ste 400, Norfolk, VA 23459 | 2017-06-08 |
| 1346686888 | Jonathan Kan | Military Health Care Provider | 1855 Helicopter Road, Virginia Beach, VA 23459 | 2013-05-10 |
| 1710276480 | Michael Monroe | Military Health Care Provider | 2520 Midway Rd, Ste 200, Eodmu Two Medical Dept, Virginia Beach, VA 23459 | 2011-04-04 |
| 1922214378 | Zachary Dukane Pryor | Military Health Care Provider | 1745 10th Street, Beach Master Unit Two, Virginia Beach, VA 23459 | 2007-05-15 |
| 1962561118 | James Andrew Church | Nurse Practitioner | 642 New Guinea Rd, Ft. Story, VA 23459 | 2006-12-06 |
| 1134226988 | Mcdonald Army Health Center | Military/U.S. Coast Guard Pharmacy | 649 New Guinea Rd, Ft Story, VA 23459 | 2006-09-20 |
| 1376946897 | Lydia Kay Andaya | Military Health Care Provider | 2220 Schofield Rd, Virginia Beach, VA 23459 | 2014-09-29 |
| 1326467754 | Sajeewane Manjula Seales | Family Medicine | Naval Medical Center Portsmouth, 1035 Nider Blvd, Virginia Beach, VA 23459 | 2014-04-14 |
| 1255677332 | Daniel Wayne Davis | Physician Assistant | 1035 Nider Blvd, Suite 100, Virginia Beach, VA 23459 | 2012-12-18 |
| Find all providers in zip 23459 | ||||
| Taxonomy Code | 332000000X |
| Grouping | Suppliers |
| Classification | Military/U.S. Coast Guard Pharmacy |
| A Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a DoD or U.S. Coast Guard clinic, DoD Hospital or freestanding. Usually associated with outpatient services. |
| Notes: Source: TRICARE Management Activity Uniform Business Office User’s Guide [1/1/2005: new; 7/1/2006: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740389865 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1185 Terrier Ave, Ste 100, Virginia Beach, VA 23461 | 2006-09-22 |
| 1578977666 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1550 Tomcat Blvd Ste 150, Naval Air Station Oceana, Virginia Beach, VA 23460-2186 | 2014-06-17 |
| 1851704431 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 2100 Lynnhaven Pkwy Ste 201, Virginia Beach, VA 23456-1492 | 2014-06-11 |
| 1396158168 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1885 Terrier Ave Ste 100, Virginia Beach, VA 23461-2205 | 2014-06-09 |
| 1952408700 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1035 Nider Blvd, Ste 100, Virginia Beach, VA 23459-8701 | 2006-09-20 |
| 1770680522 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 2100 Lynnhaven Pkwy, Ste 201, Virginia Beach, VA 23456-1492 | 2006-09-20 |
| 1225135072 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1550 Tomcat Blvd, Ste 150, Virginia Beach, VA 23460-2188 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174172183 | Naval Health Clinic Annapolis | Military/U.S. Coast Guard Pharmacy | 17457 Caffee Rd Bldg 192, Dahlgren, VA 22448-5120 | 2019-09-11 |
| 1114403961 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 7021 Harbor View Blvd, Suffolk, VA 23435-2869 | 2018-07-16 |
| 1437563269 | Fort Belvoir Community Hospital | Military/U.S. Coast Guard Pharmacy | 8651 John J Kingman Rd, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060-6200 | 2014-06-19 |
| 1508270950 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1011 Eden Way N Ste H, Chesapeake, VA 23320-2768 | 2014-06-13 |
| 1205249059 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | 1647 Admiral Taussig Blvd Bldg Cd2, Norfolk, VA 23511-2803 | 2014-06-10 |
| 1467680819 | World Class Marketing Inc | Military/U.S. Coast Guard Pharmacy | 1814 Kecoughtan Rd, Suite B, Hampton, VA 23661-2834 | 2009-06-24 |
| 1609966936 | Naval Medical Center Portsmouth | Military/U.S. Coast Guard Pharmacy | Naval Weapons Station Yorktown, Bldg 1806, Yorktown, VA 23691-0090 | 2006-10-16 |
| 1982703013 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg 3219, Ft Lee, VA 23801 | 2006-09-22 |
| 1922107044 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg P8130, Ft Lee, VA 23801 | 2006-09-22 |
| 1659470771 | 1st Medical Group Sgsl | Military/U.S. Coast Guard Pharmacy | 65 Spaatz Dr, Langley Afb, VA 23665-2027 | 2006-09-22 |
| Find all providers with the same taxonomy | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23459 |
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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.