KENNER ARMY HEALTH CLINIC


Address: 8204 Ave C, Fort Lee, VA 23801-1716
Phone: 8047349000

KENNER ARMY HEALTH CLINIC (NPI# 1215218342) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1215218342
Entity Type Organization
Organization Name KENNER ARMY HEALTH CLINIC
Other Organization Name USADC FT. LEE MOSIER
Practice Address 8204 Ave C
Fort Lee
VA 23801-1716
Mailing Address 700 24th St
Attn Pad
Fort Lee
VA 23801-1716
Practice Telephone 8047349000
Mailing Telephone 8047349306
Enumeration Date 2011-09-02
Last Update Date 2014-02-05
Authorized Official Name CARLOS RODRIGUEZ-ROSADO (NCOIC PAD)
Authorized Official Telephone 8047349299
Is Organization Subpart Y
Parent Organization Name KENNER ARMY HEALTH CLINIC

Taxonomy

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 Provider/Organization Names

Other Name Type Code
USADC FT. LEE MOSIER Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
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
1417361866 Kenner Army Health Clinic Military/U.S. Coast Guard Pharmacy 700 24th St Bldg 8130, Kenner Army Health Clinic, Fort Lee, VA 23801-1716 2014-06-13
1043591175 Kenner Army Health Clinic Clinic/Center 700 24th St, Bldg 3219 Ncxo Tmc, Fort Lee, VA 23801-1716 2011-09-02
1497036529 Kenner Army Health Clinic Clinic/Center 2601 C Ave, Tmc 2 Bld T8204, Fort Lee, VA 23801-1717 2011-09-02
1811285034 Kenner Army Health Clinic Military/U.S. Coast Guard Pharmacy 700 24th St, Kenner Army Health Clinic, Fort Lee, VA 23801-1716 2011-07-21
1689879330 Kenner Army Health Clinic Clinic/Center 2601 C Ave, Fort Lee, VA 23801-1717 2007-06-20
1164640504 Kenner Army Health Clinic Clinic/Center 700 24th St, Fort Lee, VA 23801-1716 2007-04-23
1891854014 Kenner Army Health Clinic Clinic/Center 700 24th St, Fort Lee, VA 23801-1716 2006-12-06
1356330641 Kenner Army Health Clinic Clinic/Center 700 24th St, Fort Lee, VA 23801-1716 2005-10-19

Office Location

Street Address 8204 AVE C
City FORT LEE
State VA
Zip Code 23801-1716

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790262384 Usv Optical Inc. Eyewear Supplier (Equipment, not the service) Ft. Lee 300 A Ave., Fort Lee, VA 23801 2018-07-26
1770812190 Arkeye Optometrist 300 A Avenue, Bldg 1605, Fort Lee, VA 23801 2009-12-14
1992911044 Claudis Andre' Williams Jr. Physician Assistant 700 24th St., Kenner Army Health Clinic, Ft. Lee, VA 23801 2007-05-15
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
1538135157 Laurie Sue Giertz Physician Assistant 700 24th St Apt Hill, Fort Lee, VA 23801 2006-02-24
1689653396 Robert Keith Lather Emergency Medicine Kenner Army Health Clinic, Primary Care Division, Ft Lee, VA 23801 2006-01-11
1265418370 Edward Cathright Jr. Dentist 504 Trenton Drive, Fort Lee, VA 23801 2005-12-20
1801854807 Mack Conley O'quinn Jr. Social Worker 700 24th Street, Kenner Army Health Clinic, Fort Lee, VA 23801 2006-05-02
1083690028 Kimberly Ellen Newton Registered Nurse 700 24th Street, Usameddac Kahc Attn: Credentials Office, Fort Lee, VA 23801 2005-12-21
Find all providers in zip 23801

Taxonomy Information

Taxonomy Code 261QM1100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Military/U.S. Coast Guard Outpatient

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1043591175 Kenner Army Health Clinic Clinic/Center 700 24th St, Bldg 3219 Ncxo Tmc, Fort Lee, VA 23801-1716 2011-09-02
1497036529 Kenner Army Health Clinic Clinic/Center 2601 C Ave, Tmc 2 Bld T8204, Fort Lee, VA 23801-1717 2011-09-02
1689879330 Kenner Army Health Clinic Clinic/Center 2601 C Ave, Fort Lee, VA 23801-1717 2007-06-20
1891854014 Kenner Army Health Clinic Clinic/Center 700 24th St, Fort Lee, VA 23801-1716 2006-12-06
1356330641 Kenner Army Health Clinic Clinic/Center 700 24th St, Fort Lee, VA 23801-1716 2005-10-19

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1801043252 Kenner Ahc Clinic/Center 14115 Montague Rd, Fort A P Hill, VA 22427-3115 2008-08-27
1598958308 Branch Medical Clinic The Basic School Clinic/Center 24008 Mcb #2, Quantico, VA 22134 2007-08-24
1821281908 Branch Medical Clinic Ocs Brown Field Clinic/Center 2189 Elrod Ave, Building 5003, Quantico, VA 22134-5113 2007-08-22
1447457197 Branch Medical Clinic Dahlgren Clinic/Center 192 Cassee Road, Bldg 192, Dahlgren, VA 22448-5000 2007-06-27
1821294729 Mcdonald Army Health Center Clinic/Center Building 82 Ingals, Fort Monroe, VA 23651 2007-06-26
1659577534 Mcdonald Army Health Center Clinic/Center Building 576 Stemberg Avenue, Fort Eustis, VA 23604 2007-06-26
1508062779 Mcdonald Army Health Center Clinic/Center Building 669 Monroe Avenue, Fort Eustis, VA 23604 2007-06-25
1356426894 United States Coast Guard Clinic/Center End of Route 238, Yorktown, VA 23690-5000 2006-10-25
1922199066 Mcdonald Army Health Center Clinic/Center 579 Jefferson Ave, Fort Eustis, VA 23604 2006-09-27
1821501719 Tricare Medical Clinic Suffolk Clinic/Center 1317 Ballahack Rd, Chesapeake, VA 23322-2499 2017-11-14
Find all providers with the same taxonomy

Competitor

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City FORT LEE
Zip Code 23801

Improve Information

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Dataset Information

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.

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