MADIGAN ARMY MEDICAL CENTER (NPI# 1336410646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336410646 |
| Entity Type | Organization |
| Organization Name | MADIGAN ARMY MEDICAL CENTER |
| Practice Address |
Madigan Army Medical Ctr Bldg 9040 Fitzsimmons Drive Tacoma WA 98431-0001 |
| Practice Telephone | 2539682235 |
| Mailing Telephone | 2539682235 |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-01-18 |
| Authorized Official Name | DR. MICHAEL LOUGHREN (CHIEF CRNA) |
| Authorized Official Telephone | 2539682960 |
| Authorized Official Credential | CRNA, PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2865M2000X |
Military Hospital Specialization: Military General Acute Care Hospital |
RN 60186795 | WA | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932406584 | Madigan Army Medical Center | Military Hospital | Bldg 2008b 3rd Avenue N, Tacoma, WA 98431-0001 | 2011-02-17 |
| 1740421460 | Madigan Army Medical Center | Military Hospital | Mamc Dept of Psychology, Bldg 9040 Fitzsimmons Drive, Tacoma, WA 98431-0001 | 2009-03-09 |
| 1336310267 | Madigan Army Medical Center | Military Hospital | Bldg 9040, Fitzsimmons Drive, Tacoma, WA 98431-0001 | 2008-03-19 |
| 1205898871 | Madigan Army Medical Center | Social Worker | 437 Cabrillo St, Suite Aia -us Army Health Clinic, Presido of Monterey, CA 93944 | 2006-04-06 |
| 1497270342 | Madigan Army Medical Center | Clinic/Center | 201 9th Street, Marina, CA 93933 | 2017-08-11 |
| 1003350687 | Madigan Army Medical Center | Military Hospital | 9040a Jackson Ave, Tacoma, WA 98431-0001 | 2016-12-15 |
| 1124476833 | Madigan Army Medical Center | Clinic/Center | 9040 Jackson Avenue, Apo, AA 98431 | 2016-06-03 |
| 1649624453 | Madigan Army Medical Center | General Acute Care Hospital | 9040a Jackson Ave, Att: Mchj-c-e, Tacoma, WA 98431-0001 | 2016-04-18 |
| 1578927794 | Madigan Army Medical Center | Nursing Facility/Intermediate Care Facility | 9040 A Jackson Ave, Tacoma, WA 98431-1100 | 2016-04-13 |
| 1346608924 | Madigan Army Medical Center | Military Hospital | Madigan Army Medical Ctr, 9040 Reid Street, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2016-02-10 |
| Street Address |
MADIGAN ARMY MEDICAL CTR BLDG 9040 FITZSIMMONS DRIVE |
| City | TACOMA |
| State | WA |
| Zip Code | 98431-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033114954 | Larry E Witham | Physician Assistant | Madigan Army Medical Ctr, 9040a Reid Street, Tacoma, WA 98431-1100 | 2005-06-16 |
| 1417483512 | Carah Labrier | Emergency Medical Technician, Basic | Madigan Army Medical Ctr, 9040 Jackson Aveunue, Tacoma, WA 98431-0001 | 2017-05-10 |
| 1396270823 | Cherise Janen Hartman | Pharmacy Technician | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-04-21 |
| 1356876924 | Joseph Durso | Student in an Organized Health Care Education/Training Program | Madigan Army Medical Ctr, 9040 Jackson Avenue, Tacoma, WA 98431-0001 | 2017-04-20 |
| 1891228474 | Alfonso David Bernal-stevens | Emergency Medical Technician, Basic | Madigan Army Medical Ctr, 9040 Jackson Ave, Attn Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-04-10 |
| 1730612573 | Tifani Mcgovern | Registered Nurse | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-0001 | 2017-04-08 |
| 1770024184 | Susan Marie Beale | Licensed Practical Nurse | Madigan Army Medical Ctr, 9040 Jackson Ave, Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-17 |
| 1417498957 | Danielle Jones | Pharmacy Technician | Madigan Army Medical Ctr, 9040 Jackson Ave. Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-16 |
| 1962943514 | Edwin Pampo | Registered Nurse | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-15 |
| 1497296578 | Margie Ayala | Technician, Pathology | Madigan Army Medical Ctr, 9040 Jackson Ave Attn: Mchj-clq-c, Tacoma, WA 98431-1100 | 2017-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 2865M2000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| Specialization | Military General Acute Care Hospital |
| A Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in "fixed" facilities, primarily for DoD beneficiaries. Entity is Defense Health Program (DHP) funded. A "fixed" facility is a non-temporary, non-deployed facility usually used for health care services. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes those services and institutional costs usually included in a Diagnosis Related Group as well as "pass-through" items. |
| Notes: [1/1/2005: title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346654050 | Samantha Josefine Moana Brodehl | Military Hospital | 1601 E Fourth Plain Blvd, Vancouver, WA 98661-3753 | 2014-06-20 |
| 1982962148 | Veterans Hospital | Military Hospital | 1660 S Columbian Way, Seattle, WA 98108-1532 | 2012-04-25 |
| 1972825008 | Va Puget Sound | Military Hospital | 1660 S Columbian Way, Seattle, WA 98108-1532 | 2010-02-16 |
| 1982872347 | Jennifer Lynn Oltyan | Military Hospital | 1660 S Columbian Way, Seattle, WA 98108-1532 | 2008-02-19 |
| 1952597635 | Va Puget Sound Health Care System | Military Hospital | 1660 S Columbian Way, Seattle, WA 98108 | 2007-09-17 |
| 1730134206 | Naval Health Clinic Oak Harbor | Military Hospital | 3475 N Saratoga St, Oak Harbor, WA 98278-8800 | 2006-05-23 |
| 1427010420 | Naval Hospital Bremerton | Military Hospital | 1 Boone Rd, Code 08razd, Bremerton, WA 98312-1898 | 2006-04-05 |
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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.