WOMACK ARMY MEDICAL CENTER (NPI# 1467660431) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467660431 |
| Entity Type | Organization |
| Organization Name | WOMACK ARMY MEDICAL CENTER |
| Other Organization Name | OCC HLTH NSG OFF-SUNNY POINT |
| Practice Address |
6280 Sunny Point Rd Occ Health Clinic Military Ocean Terminal Sunny Point Southport NC 28461-7800 |
| Mailing Address |
2817 Reilly St Mcxc-dbo-ub Wamc Stop A Fort Bragg NC 28310-7324 |
| Practice Telephone | 9109079262 |
| Mailing Telephone | 9109076693 |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2013-02-11 |
| Authorized Official Name | BARBARA BLACK (UBO MANAGER) |
| Authorized Official Telephone | 9109078537 |
| Is Organization Subpart | Y |
| Parent Organization Name | WOMACK 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 |
|---|---|---|---|
| BCBS UB-04 PROVIDER ID | 00539 | 01 | |
| BCBS CMS 1500 PROVIDER ID | 0294A | 01 | |
| PARENT FACILITY NPI | 1740377423 | 01 |
| Other Name | Type Code |
|---|---|
| OCC HLTH NSG OFF-SUNNY POINT | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356907471 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 4-2817 Reilly Rd Bldg B, Fort Bragg, NC 28310-0001 | 2019-05-14 |
| 1891246708 | Womack Army Medical Center | Pharmacy | 1571 Reilly Rd, Bldg 4, Ft Bragg, NC 28307 | 2016-10-17 |
| 1861867293 | Womack Army Medical Center | Military Hospital | 2817 Reily Road, Fort Bragg, NC 28317 | 2015-12-10 |
| 1700250248 | Womack Army Medical Center | Rehabilitation Unit | 215 Ice Ave, 100, Dayton, OH 45402 | 2015-11-20 |
| 1205206935 | Womack Army Medical Center | Clinic/Center | 3908 Longstreet, Bldg 3-4303, Fort Bragg, NC 28310-0001 | 2015-10-07 |
| 1932577368 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 55 Centennial Pkwy, Cameron, NC 28326-4013 | 2015-09-02 |
| 1578951042 | Womack Army Medical Center | Clinic/Center | 55 Centennial Parkway, Cameron, NC 28326 | 2015-01-06 |
| 1801215660 | Womack Army Medical Center | Clinic/Center | 2857 Watson St, Bldg M-1704, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1710306576 | Womack Army Medical Center | Clinic/Center | Tagaytay Rd Bldg C-1624, Fort Bragg, NC 28310-7301 | 2014-04-09 |
| 1508285362 | Womack Army Medical Center | Clinic/Center | Kendenburg St Bldg H-6338, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| Street Address |
6280 SUNNY POINT RD OCC HEALTH CLINIC MILITARY OCEAN TERMINAL SUNNY POINT |
| City | SOUTHPORT |
| State | NC |
| Zip Code | 28461-7800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205319050 | Leon Bass Jr. | Emergency Medicine | 6280 Sunny Point Rd, Bldg 44, Southport, NC 28461-7800 | 2018-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225645542 | Island Time Medical and Wellness, Pllc | Clinic/Center | 39 Dowitcher Trl, Bald Head Island, NC 28461 | 2020-09-30 |
| 1871095356 | Sunny Point Fire & Rescue | Emergency Medicine | 6280 Sunny Point Rd Bldg 44, Southport, NC 28461 | 2018-03-01 |
| 1962882035 | Kimberlee Kreuzer | Physical Therapist | 1517 N Howe St Suite 4, Southport, NC 28461 | 2015-06-04 |
| 1134449291 | Kristos Nektarios Vaughan | Family Medicine | 3009 Medical Plaza Lane, Southport, NC 28461 | 2010-06-10 |
| 1750612974 | Melissa Holden | Nurse Practitioner | 1517 N Howe St Ste 12, Southport, NC 28461 | 2010-01-28 |
| 1437315165 | North Carolina Shoulder and Elbow Surgery and Sports Medicine | Orthopaedic Surgery | 900 North Howe St, Southport, NC 28461 | 2008-08-01 |
| 1124212329 | Edward Frank Babel | Nurse Practitioner | 201 West Boiling Spring Lakes Road, New Hope Clinic, Boiling Spring Lakes, NC 28461 | 2007-08-30 |
| 1952453151 | Robert Wayne Poe | Otolaryngology | 900 N. Howe St, Southport, NC 28461 | 2007-01-17 |
| 1275640898 | Kurt Thomas Scheetz | Dentist | 1301 N Howe Street, Southport, NC 28461 | 2006-08-23 |
| 1396859872 | Brunswick Family Medicine Pa | Family Medicine | 3960 Executive Park Blvd, Unit 600, Southport, NC 28461 | 2006-08-19 |
| Find all providers in zip 28461 | ||||
| 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 |
|---|---|---|---|---|
| 1205206935 | Womack Army Medical Center | Clinic/Center | 3908 Longstreet, Bldg 3-4303, Fort Bragg, NC 28310-0001 | 2015-10-07 |
| 1235508557 | United States Navy | Clinic/Center | Psc Box 20098, Hq and Service Co, 1st Bn, 6th Marine Regt, 2d Mardiv, Camp Lejeune, NC 28542-0098 | 2015-09-16 |
| 1578951042 | Womack Army Medical Center | Clinic/Center | 55 Centennial Parkway, Cameron, NC 28326 | 2015-01-06 |
| 1801215660 | Womack Army Medical Center | Clinic/Center | 2857 Watson St, Bldg M-1704, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1710306576 | Womack Army Medical Center | Clinic/Center | Tagaytay Rd Bldg C-1624, Fort Bragg, NC 28310-7301 | 2014-04-09 |
| 1508285362 | Womack Army Medical Center | Clinic/Center | Kendenburg St Bldg H-6338, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1134433402 | Womack Army Medical Center | Clinic/Center | 2356 South Peak Drive, Hope Mills, NC 28348 | 2010-07-29 |
| 1760795769 | Womack Army Medical Center | Clinic/Center | 2350 Bentridge Ln, Woodland Bldg, Fayetteville, NC 28304-0586 | 2010-07-19 |
| 1003051210 | Us Army | Clinic/Center | 5587 Lockridge Road, Fayetteville, NC 28311 | 2008-12-03 |
| 1942495270 | Branch Medical Clinic Camp Geiger Mcb | Clinic/Center | 100 Brewster Blvd - Code 08/zd, Camp Lejeune, NC 28547-2538 | 2007-09-10 |
| Find all providers with the same taxonomy | ||||
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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.