USCG AIR STATION PORT ANGELES MEDCIAL/DENTAL CLINIC (NPI# 1477538361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477538361 |
| Entity Type | Organization |
| Organization Name | USCG AIR STATION PORT ANGELES MEDCIAL/DENTAL CLINIC |
| Other Organization Name | GERSHOWITZ CLINIC |
| Practice Address |
Commandant Uscg Hq (cg-1122) 2100 2nd Street Washington DC 20593-0001 |
| Practice Telephone | 2022670801 |
| Mailing Telephone | 2022670801 |
| Enumeration Date | 2005-12-13 |
| Last Update Date | 2010-08-18 |
| NPI Deactivation Date | 06/03/2008 |
| NPI Reactivation Date | 2010-08-17 |
| Authorized Official Name | STEPHEN J KINSLEY (SENIOR HEALTH SERVICES OFFICER) |
| Authorized Official Telephone | 3604175894 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| 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 |
| Other Name | Type Code |
|---|---|
| Gershowitz Clinic | Other Name - Individual/Organization |
| Street Address |
COMMANDANT USCG HQ (CG-1122) 2100 2ND STREET |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20593-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538144993 | David Bruce Lloyd | Dentist | Commandant Uscg Hq (cg-1122), 2100 2nd Street, Washington, DC 20593-0001 | 2005-12-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982869939 | Devon Avery | Student in an Organized Health Care Education/Training Program | 21002ndst Sw Swite 5314, Washington, DC 20593 | 2008-07-18 |
| 1922261056 | Robert Harold Spicer | Technician, Other | 2100 2nd St, Comdt (cg-1122) U.S. Coasst Guard Suite 5314, Washington, DC 20593 | 2008-07-09 |
| 1235391772 | Abby Joanna Shannon | Dentist | Uscg Base Ncr 2703 Martin Luther King Jr Ave Se, Washington, DC 20593 | 2008-06-26 |
| 1760642797 | Sweet-charity May Keplinger | Physician Assistant | 2100 2nd St Sw Suite 5, Comdt ( Cg-1122) Us Coast Guard, Washington, DC 20593 | 2008-06-12 |
| 1730346719 | Stephen M-l Tate | Student in an Organized Health Care Education/Training Program | 2100 2nd St Sw Suit, Comdt (cg-1122) Us Coast Guard, Washington, DC 20593 | 2008-05-19 |
| 1659409167 | Marc J Capra | Technician, Other | Uscg Comdt (cg-1122), 2100 2nd St Sw Suite 5314, Washington, DC 20593 | 2007-02-28 |
| 1336220730 | Christohper John Lisk | Technician, Other | 2100 2nd St Sw Suite 5314, Comdt (cg-1122) U.S. Coast Guard, Washington, DC 20593 | 2006-10-18 |
| 1013097674 | James C. Morgan | Military Health Care Provider | Comdt (cg-1122), U.S. Coast Guard 2100 2nd St Sw, Suite 5314, Washington, DC 20593 | 2006-10-17 |
| 1811077613 | Thomas Keith Heimann | Technician, Other | 2100 2nd St Sw, Suite 5314, Comdt (cg-1122), U. S. Coast Guard, Washington, DC 20593 | 2006-10-16 |
| 1447330246 | Unitied States Coast Guard | Technician, Other | 2100 2nd St Sw Comdt (cg-1122), Suite 5314 Us Coast Guard, Washington, DC 20593 | 2006-10-16 |
| Find all providers in zip 20593 | ||||
| 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 |
|---|---|---|---|---|
| 1265639918 | Branch Medical Clinic Washington Navy Yard | Clinic/Center | 915 N Street Southeast, Suite 210, Washington, DC 20374-5162 | 2007-06-27 |
| 1881897544 | National Naval Medical Center | Clinic/Center | The Pentagon, Corridor 8, Washington, DC 20310-0001 | 2007-06-08 |
| 1467538371 | Uscg Headquarters Support Command (k) | Clinic/Center | Comdt 2100 2nd St Sw, Cg-1122, Suite 5314, Washington, DC 20593-0001 | 2006-10-31 |
| 1033312798 | Wramc | Clinic/Center | 6900 Georgia Ave, Usadc, Washington, DC 20310-0001 | 2007-06-08 |
| 1205042926 | Wramc | Clinic/Center | Pentagon, Washington, DC 20310-0001 | 2007-05-16 |
| 1285759712 | Uscg Ralph Nix Medical | Clinic/Center | Uscg Hq Comdt (cg-1122), 2100 Second Street South West, Washington, DC 20593-0001 | 2007-03-21 |
| 1740325380 | Uscg Air Station Barbers Point Clinic | Clinic/Center | Comdt Cg-1122, Washington, DC 20593-0001 | 2007-02-21 |
| 1326191073 | U.s Coast Guard | Clinic/Center | 2100 2nd St Sw, Suite 5314, Washington, DC 20593-0002 | 2007-01-18 |
| 1003968942 | Uscg Isc San Pedro Clinic | Clinic/Center | 2100 2nd St Sw, Suite 5314, Washington, DC 20593-0002 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154526812 | Wramc | Clinic/Center | 103 3rd Ave Sw, Fort Mcnair, DC 20024-5120 | 2007-06-20 |
| City | WASHINGTON |
| Zip Code | 20593 |
Please comment or provide details below to improve the information on USCG AIR STATION PORT ANGELES MEDCIAL/DENTAL CLINIC.
| 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.