21ST MEDICAL GROUP (NPI# 1285012922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285012922 |
| Entity Type | Organization |
| Organization Name | 21ST MEDICAL GROUP |
| Other Organization Name | SCHRIEVER REFILL PCTR PHCY |
| Practice Address |
220 Falcon Pkwy Bldg 220 Colorado Springs CO 80912-5005 |
| Mailing Address |
21st Medical Group C/o Rmo Office 559 Vincent St Peterson Afb CO 80914-1541 |
| Practice Telephone | 7195674423 |
| Practice Fax Number | 7195674817 |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2016-01-15 |
| Authorized Official Name | HECTOR MORALES (CHIEF DHA PASS) |
| Authorized Official Telephone | 2105366650 |
| Is Organization Subpart | N |
| 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 | 2151923 | 01 |
| Other Name | Type Code |
|---|---|
| SCHRIEVER REFILL PCTR PHCY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932514171 | 21st Medical Group | Pharmacy | 110 W Ent Ave, Peterson Afb, CO 80914-1595 | 2014-06-26 |
| 1487069621 | 21st Medical Group | Military/U.S. Coast Guard Pharmacy | 220 Falcon Pkwy, Schriever Afb, CO 80912-5005 | 2014-06-26 |
| 1548369259 | 21st Medical Group | Pharmacy | 559 Vincent St, Peterson Afb, CO 80914-1541 | 2006-09-21 |
| 1942286224 | 21st Medical Group | Clinic/Center | 559 Vincent St, Peterson Afb, CO 80914-1541 | 2005-12-19 |
| Street Address |
220 FALCON PKWY BLDG 220 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80912-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164412441 | Brent Sonday | Dentist | 220 Falcon Parkway, Schriever, Afb, CO 80912 | 2005-10-26 |
| 1679672380 | 21 Medical Group | Military/U.S. Coast Guard Pharmacy | 220 Falcon Pkwy, Schriever Afb, CO 80912-5005 | 2006-09-21 |
| 1487069621 | 21st Medical Group | Military/U.S. Coast Guard Pharmacy | 220 Falcon Pkwy, Schriever Afb, CO 80912-5005 | 2014-06-26 |
| 1346580081 | William Taylor Timberlake IIi | Military Health Care Provider | 220 Falcon Pkwy, Schriever Afb, CO 80912-5005 | 2013-02-17 |
| 1912270786 | Steven Edward Savage | Dentist | 220 Falcon Pkwy, Schriever Afb, CO 80912-5005 | 2012-02-09 |
| 1912152562 | Jason Lee Baker | Physician Assistant | 220 Falcon Pkwy, Schriever Afb, CO 80912-5005 | 2008-11-24 |
| 1619159456 | Richard J Navarez Jr. | Physician Assistant | 220 Falcon Pkwy, 21 Medical Sq, Colorado Springs, CO 80912-5005 | 2007-12-04 |
| 1922392265 | Branden Richard Crockett | Physical Therapist | 210 Falcon Pkwy Ste 2102, Colorado Springs, CO 80912-5006 | 2011-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013860 | Pueblo Radiological Group, P.C. | Radiology | 245 Balmoral Way, Colorado Springs, CO 80906-7907 | 2020-11-06 |
| 1285235127 | Matthews-vu Medical Group, P.C. | Clinic/Center | 4190 E Woodmen Rd Ste 230, Colorado Springs, CO 80920-8075 | 2020-11-06 |
| 1356942171 | Colorado Otolaryngology Associates, LLC | Specialist | 6031 E. Woodmen Rd., Ste. 300, Colorado Springs, CO 80923 | 2020-11-06 |
| 1548861529 | Pueblo Radiological Group, P.C. | Radiology | 1804 Oakmoor Hts, Colorado Springs, CO 80906-1171 | 2020-11-05 |
| 1043811904 | Cassondra Tina Marie Chagnon | Counselor | 6315 Council Pt Apt 204, Colorado Springs, CO 80923-5136 | 2020-11-05 |
| 1841891074 | Kristen Gutierrez | Massage Therapist | 6270 Lehman Dr Ste 250, Colorado Springs, CO 80918-1450 | 2020-11-04 |
| 1619578093 | Total Initiative Pursuit LLC | Behavioral Analyst | 5474 Jessica Ct, Colorado Springs, CO 80917-4218 | 2020-11-03 |
| 1699376038 | Penrad Imaging LLC | Clinic/Center | 2202 N Nevada Ave, Colorado Springs, CO 80907-6819 | 2020-11-03 |
| 1346841616 | Therese Inman | Doula | 5370 Artistic Cir, Colorado Springs, CO 80917-2239 | 2020-11-03 |
| 1922609395 | Emily Nearing | Student in an Organized Health Care Education/Training Program | 2425 N Wahsatch Ave, Colorado Springs, CO 80907-6942 | 2020-11-03 |
| Find all providers in COLORADO SPRINGS | ||||
| 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 |
|---|---|---|---|---|
| 1861623936 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 3220 Union Blvd, Colorado Springs, CO 80907-4900 | 2009-08-06 |
| 1154742583 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 565 Space Center Dr, Suite 130, Colorado Springs, CO 80915-3609 | 2014-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982010955 | Usafa 10th Medical Group/sgsbr | Military/U.S. Coast Guard Pharmacy | 8118 Park Dr, Usaf Academy, CO 80840-2397 | 2014-07-10 |
| 1265845036 | Military Treatment Facility | Military/U.S. Coast Guard Pharmacy | 13611 E. Colfax Ave., Buckley Afb, CO 80011-9547 | 2014-06-09 |
| 1518173236 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 7490 Sutherland Circle, Robinson Family Medicine Clinic, Fort Carson, CO 80913-4603 | 2007-05-16 |
| 1164512497 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Evans Ach 7500 Cochrane Circle, Evans Army Community Hospital, Ft Carson, CO 80913-4603 | 2006-10-16 |
| 1679672380 | 21 Medical Group | Military/U.S. Coast Guard Pharmacy | 220 Falcon Pkwy, Schriever Afb, CO 80912-5005 | 2006-09-21 |
| 1518066273 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 6351 Wetzel Ave, Bldg 1525, Ft Carson, CO 80913-4188 | 2006-09-21 |
| 1114026820 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 7490 Southerland Circle, Robinson Clinic, Ft Carson, CO 80913 | 2006-09-21 |
| 1043319858 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 6911 Titus Blvd Bldg 2353, Ft Carson, CO 80913-4429 | 2006-09-21 |
| 1841397692 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 8119 Park Dr, Usaf Academy, CO 80840-2397 | 2006-09-20 |
| 1932206786 | 460th Medical Logistics Whs | Military/U.S. Coast Guard Pharmacy | 317 N Telluride St, Bldg 7, Buckley Afb, CO 80011-7809 | 2006-09-20 |
| Find all providers with the same taxonomy | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80912 |
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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.