U.S. NAVY (NPI# 1477564870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477564870 |
| Entity Type | Organization |
| Organization Name | U.S. NAVY |
| Practice Address |
Box 159 Navsubasenlon Naval Undersea Medical Institute Groton CT 06340-5159 |
| Mailing Address |
Po Box 159 Box 159 Navsubasenlon Groton CT 06340-5159 |
| Practice Telephone | 8606942876 |
| Practice Fax Number | 8606943696 |
| Mailing Telephone | 8606942876 |
| Mailing Fax Number | 8606943696 |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | EDWARD THEODORE MILLER (INDEPENDENT DUTY CORPSMAN) |
| Authorized Official Telephone | 8606342876 |
| Authorized Official Credential | IDC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841207024 | U.S. Navy | Nursing Facility/Intermediate Care Facility | Pcs 827 Box 79, Fpo, NAPLES AE | 2006-08-01 |
| 1265406573 | U.S. Navy | Emergency Medicine | 3800 Bob Wilson Drive, Nmcsd- Emergency Medicine Department, San Diego, CA 92134 | 2006-02-14 |
| 1518360072 | U.S. Navy | Clinic/Center | 4755 Pasture Rd, Fallon, NV 89496-3115 | 2014-09-29 |
| 1487918629 | U.S. Navy | Military Hospital | 350 Crag Rd, Panama City, FL 32407-7013 | 2012-07-03 |
| 1699070847 | U.S. Navy | Military Hospital | National Naval Medical Ctr, 8901 Wisconsin Avenue, Bethesda, MD 20889-5600 | 2011-01-19 |
| 1659566933 | U.S. Navy | Clinic/Center | 3rd Med Bn, 3rd Mlg, Hansen Clinic, Unit 38448, Okinawa, FPO AP | 2007-09-11 |
| 1417024837 | U.S. Navy | Military Hospital | 620 John Paul Jones Circle, Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2006-11-29 |
| 1538120068 | U.S. Navy | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2006-04-02 |
| 1932182052 | U.S. Navy | Family Medicine | 480 Central Ave, Naval Health Clinic Hawaii, Pearl Harbor, HI 96860-4908 | 2005-11-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNITED STATES NAVY MEMORIAL FOUNDATION | 701 Pennsylvania Ave Nw Ste 123, Washington, DC 20004-2688 |
| Oklahoma Business Registrations | UNITED STATES NAVY MEMORIAL FOUNDATION | 701 Pennsylvania Ave Nw #123, Washington, DC 20004-2608 |
| Colorado Business Entities | UNIVERSAL SPACE NAVY LLC | 1212 E Monument, Colorado Springs, CO 80909 |
| System for Award Management (SAM) Entities | URS ONYX WORLDWIDE NAVY IQC, LLC | 12420 Milestone Center Dr # 150, Germantown, MD 20876-7112 |
| Street Address |
BOX 159 NAVSUBASENLON NAVAL UNDERSEA MEDICAL INSTITUTE |
| City | GROTON |
| State | CT |
| Zip Code | 06340-5159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063052819 | Kenny Daniel Harp | Military Health Care Provider | 59 Deerwood Dr, Groton, CT 06340-2513 | 2020-01-09 |
| 1982244737 | Lonnie Jay Reardon | Military Health Care Provider | 55 South Rd Apt 12c, Groton, CT 06340-4660 | 2020-01-09 |
| 1376194274 | Christopher Lee Roy Smith | Military Health Care Provider | Uss San Juan (ssn 751), Groton, CT 06349 | 2019-09-23 |
| 1679132112 | Hector Salvador Gonzalez | Military Health Care Provider | 2 Bushnell St, Groton, CT 06340-3306 | 2019-06-09 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1558929026 | Joshua Darren Savage | Military Health Care Provider | 35 Chrissos St, Groton, CT 06340-3307 | 2019-05-30 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1689179640 | David Saunders | Military Health Care Provider | 159 Navsubase Nlon, Groton, CT 06349 | 2018-03-29 |
| 1992241228 | Phillip Lawernce Hardy Sr. | Military Health Care Provider | 123 Trout Ave, Naval Undersea Medical Institiute, Groton, CT 06340-5159 | 2017-01-10 |
| Find all providers in GROTON | ||||
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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.