WILLIAM BEAUMONT ARMY MEDICAL CENTER (NPI# 1326527177) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326527177 |
| Entity Type | Organization |
| Organization Name | WILLIAM BEAUMONT ARMY MEDICAL CENTER |
| Other Organization Name | SENIOR LEADER SUSTAINMENT USASMA |
| Practice Address |
11291 Sgt E Churchill St Fort Bliss TX 79918-8001 |
| Mailing Address |
5005 N Piedras St Attn Treasurer's Office El Paso TX 79920-5001 |
| Practice Telephone | 9157426199 |
| Mailing Telephone | 9157426199 |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2018-08-13 |
| Authorized Official Name | NATIVIDAD GONZALEZ (MEDICAL SERVICES ACCOUNTS OFFICER) |
| Authorized Official Telephone | 9157422753 |
| Is Organization Subpart | Y |
| Parent Organization Name | WILLIAM BEAUMONT 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PARENT FACILITY WILLIAM BEAUMONT AMC NPI | 1295838787 | 01 |
| Other Name | Type Code |
|---|---|
| Senior Leader Sustainment USASMA | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952716896 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1363 Aberdeen Road, White Sands Missile Range, NM 88002-5520 | 2014-06-30 |
| 1629322144 | William Beaumont Army Medical Center | Clinic/Center | Torch St Bldg 21227, Dental Clinic, Fort Bliss, TX 79916 | 2012-11-06 |
| 1366796880 | William Beaumont Army Medical Center | Clinic/Center | Bldg 21227 Torch Street, Fort Bliss, TX 79916 | 2012-11-06 |
| 1134479413 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | Torch St Rm C101, Bldg 21227, Ft Bliss, TX 79916 | 2012-09-14 |
| 1962718726 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | Haan Rd, Ste A-11 Bldg 1611, Ft Bliss, TX 79916 | 2010-08-31 |
| 1316253297 | William Beaumont Army Medical Center | Military/U.S. Coast Guard Pharmacy | Hawk Rd, Rm 9503-11, Chaparrel, NM 88021 | 2010-08-30 |
| 1649476474 | William Beaumont Army Medical Center | Clinic/Center | Bldg 11281, Biggs Dental Clinic, Ft Bliss, TX 79920 | 2007-06-27 |
| 1629274105 | William Beaumont Army Medical Center | Clinic/Center | 525 Rock Island, White Sands, NM 88002 | 2007-06-22 |
| 1467667287 | William Beaumont Army Medical Center | Clinic/Center | Ricker Road Bldg 2496, Sfmc, Fort Bliss, TX 79920 | 2007-05-14 |
| 1669687489 | William Beaumont Army Medical Center | Clinic/Center | Ssg Sims Street Bldg 11335, Mendoza Soldier Family Care Clinic, El Paso, TX 79920 | 2007-05-14 |
| Street Address |
11291 SGT E CHURCHILL ST |
| City | FORT BLISS |
| State | TX |
| Zip Code | 79918-8001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952951261 | Brian Jun Hwangpo | Dentist | 21227 Torch St, Biggs Field, TX 79918 | 2019-09-18 |
| 1700355237 | William Christopher Petty | Military Health Care Provider | 21227 Torch Street, Biggs Field, TX 79918 | 2018-11-14 |
| 1598245755 | Jessica Tan | Physical Therapist | 11335 Ssg Sims St., El Paso, TX 79918 | 2018-08-17 |
| 1447798749 | Richard Emil Stanford Jr. | Physical Therapist | 11335 Ssg Sims, Ft Bliss, TX 79918 | 2017-02-07 |
| 1760736904 | Jennifer E Zuccarelli | Family Medicine | 11335 Ssg Sims St, Fort Bliss, TX 79918 | 2012-11-08 |
| 1952601254 | Sharon Anne Gutierrez | Nurse Practitioner | Bldg. 11335 Ssg Sims St., Biggs Af, Ft Bliss, TX 79918 | 2010-11-02 |
| 1972737245 | Fawn Ison | Military Health Care Provider | 11319 Ssg Sims St, Fort Bliss, TX 79918 | 2009-05-14 |
| 1447434782 | William Beaumont Army Medical | Military/U.S. Coast Guard Pharmacy | Biggs Army Airfield, Bldg 11281, Ft Bliss, TX 79918 | 2007-12-21 |
| 1073114435 | Jorge Augusto Delgadillo | Social Worker | 11335 Ssg Sims St, Fort Bliss, TX 79918 | 2020-11-03 |
| 1710586862 | Natalie Beale | Physical Therapist | 11335 Ssg Sims St, Fort Bliss, TX 79918 | 2020-10-20 |
| Find all providers in zip 79918 | ||||
| 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 |
|---|---|---|---|---|
| 1629322144 | William Beaumont Army Medical Center | Clinic/Center | Torch St Bldg 21227, Dental Clinic, Fort Bliss, TX 79916 | 2012-11-06 |
| 1366796880 | William Beaumont Army Medical Center | Clinic/Center | Bldg 21227 Torch Street, Fort Bliss, TX 79916 | 2012-11-06 |
| 1467667287 | William Beaumont Army Medical Center | Clinic/Center | Ricker Road Bldg 2496, Sfmc, Fort Bliss, TX 79920 | 2007-05-14 |
| 1487850806 | William Beaumont Army Medical Center | Clinic/Center | 2954 Carrington Road, Fort Bliss, TX 79920 | 2007-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124505359 | Carl R Darnall Army Medical Center | Clinic/Center | 5200 Bunny Trail, Killeen, TX 76549 | 2018-07-20 |
| 1568948933 | Carl R Darnall Army Medical Center | Clinic/Center | 415 31st and 761st Tank Battalion, Fort Hood, TX 76544 | 2018-07-18 |
| 1740766112 | Carl R Darnall Army Medical Center | Clinic/Center | Bldg 2255 52nd and 761st Tank Battalion, Fort Hood, TX 76544 | 2018-07-18 |
| 1396119681 | Brooke Army Medical Center | Clinic/Center | 2407 N New Braunfels, Bldg 147, Ft Sam Houston, TX 78234 | 2015-11-24 |
| 1932595204 | Carl R Darnall Army Medical Center | Clinic/Center | 9410 19th St, Fort Hood, TX 76544 | 2015-04-13 |
| 1154717650 | Carl R Darnall Army Medical Center | Clinic/Center | 31002 74th Street, Fort Hood, TX 76544 | 2015-04-10 |
| 1073909578 | Carl R Darnall Army Medical Center | Clinic/Center | 37016 77th Street, Fort Hood, TX 76544 | 2015-04-10 |
| 1972999472 | Carl R Darnall Army Medical Center | Clinic/Center | 24001 Battalion Ave, 58th and 62nd Streets, Fort Hood, TX 76544 | 2015-04-10 |
| 1619365285 | Brooke Army Medical Center | Clinic/Center | 10010 Rogers Run, Suite 100, San Antonio, TX 78251-4403 | 2015-01-05 |
| 1548693526 | Brooke Army Medical Center | Clinic/Center | 5410 Mac Williams Rd, Bldg 5026 Camp Bullis, San Antonio, TX 78257 | 2013-08-14 |
| Find all providers with the same taxonomy | ||||
| City | FORT BLISS |
| Zip Code | 79918 |
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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.