BRANCH MEDICAL CLINIC MID-SOUTH (NPI# 1245295971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245295971 |
| Entity Type | Organization |
| Organization Name | BRANCH MEDICAL CLINIC MID-SOUTH |
| Practice Address |
5722 Integrity Dr Millington TN 38054-5021 |
| Mailing Address |
6000 W Highway 98 Pensacola FL 32512-0003 |
| Practice Telephone | 9018746100 |
| Practice Fax Number | 9018746103 |
| Mailing Telephone | 8505056910 |
| Mailing Fax Number | 8505056908 |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2017-11-08 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL PENSACOLA |
| 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 |
| Street Address |
5722 INTEGRITY DR |
| City | MILLINGTON |
| State | TN |
| Zip Code | 38054-5021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124004601 | David Lynn Bell Jr. | Dentist | 5722 Integrity Dr, Nbhc Nsa Mid-south, Millington, TN 38054-5028 | 2005-12-16 |
| 1609234509 | Meoshe Beckworth | Physician Assistant | 5722 Integrity Dr, Building S-771, Millington, TN 38054-5028 | 2016-02-05 |
| 1144690603 | Thomas Korte | Dentist | 5722 Integrity Dr, Bldg S771, Millington, TN 38054-5028 | 2015-09-28 |
| 1508152836 | Whitney Pugh Millican | Nurse Practitioner | 5722 Integrity Dr, Millington, TN 38054-5028 | 2011-06-24 |
| 1730339276 | Ann Morgan Macdonald | Optometrist | 5722 Integrity Dr, Nbhc Nsa Mid-south, Millington, TN 38054-5028 | 2008-09-21 |
| 1134380033 | Terence C Hilger | Dentist | 5722 Integrity Dr, B S-771 Nav Sup Act Mid South, Millington, TN 38054-5028 | 2008-06-23 |
| 1730367020 | Alexander Joseph Mabile IIi | Military Health Care Provider | 5722 Integrity Dr, Navmac, Millington, TN 38054-5028 | 2008-02-08 |
| 1295926160 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 5722 Integrity Dr, Bldg S-771, Millington, TN 38054-5028 | 2007-08-06 |
| 1669674818 | Mark David Narduzzi | Military Health Care Provider | 5722 Integrity Dr, Bldg S-771, Millington, TN 38054-5028 | 2007-06-01 |
| 1700960192 | Jonathan David Karaman | Dentist | 5722 Integrity Dr, Millington, TN 38054-5028 | 2006-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073137758 | Stephanie Nicole Zuckerman | Psychologist | Intrepid Street, Bldg. S-771, Millington, TN 38054 | 2020-05-29 |
| 1992243000 | Paul Livernois | Pharmacist | S-752 Tarawa Ave, Millington, TN 38054 | 2017-02-09 |
| 1962751149 | Megan Nicole Seay Shelton | Dentist | 5722 Integrity Drive Building S-771, Millington, TN 38054 | 2012-09-05 |
| 1710208178 | Michael W Johns | Family Medicine | 5722 Intregrity Dr. Bldg. S771, Branch Medical Clinic Nsa Mid-south, Millington, TN 38054 | 2010-06-18 |
| 1053526996 | Ira N.b. Davis | Optometrist | Nex - Midsouth, Bldg S752, Millington, TN 38054 | 2007-05-14 |
| 1487746236 | Robert Dennis Preston Jr. | Military Health Care Provider | Brach Medical Clinic, Naval Support Activity Mid-south, Millington, TN 38054 | 2006-09-29 |
| 1366486086 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Nex - Navy Support Activity - Memphis, Bldg. S752, Millington, TN 38054 | 2006-06-15 |
| 1710948245 | James R Luedtke | Technician, Other | 5722 Integrity Drive, Bldg S771, Nbhc, Nsa Mid-south, Millington, TN 38054 | 2006-04-02 |
| 1316915333 | Charles Barry Collier | Military Health Care Provider | Branch Medical Clinic, Nsa Mid South, 5722 Integrity Dr Bldg, Millington, TN 38054 | 2006-03-08 |
| 1154391977 | Jose Calixto De La Pena | Family Medicine | 5722 Intergrity Dr., Blgd S771 (nbhc Midsouth, Millington, TN 38054 | 2006-01-24 |
| Find all providers in zip 38054 | ||||
| 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 |
|---|---|---|---|---|
| 1275846263 | Blanchfield Army Community Hospital | Clinic/Center | 647 Dunlop Ln, Gateway Medical Center Medical Office Bldg One, Clarksville, TN 37040-5165 | 2010-07-19 |
| City | MILLINGTON |
| Zip Code | 38054 |
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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.