65 MEDICAL GROUP (NPI# 1487624466) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487624466 |
| Entity Type | Organization |
| Organization Name | 65 MEDICAL GROUP |
| Practice Address |
Unit 7745 Apo AE 09720 PT |
| Practice Telephone | 011351295573239 |
| Practice Fax Number | 011351295574214 |
| Mailing Telephone | 011351295573239 |
| Mailing Fax Number | 011351295574214 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHRISTOPHER DOUGLAS EATON (AIR FORCE UNIFORM BUSINESS OFFICE P) |
| Authorized Official Telephone | 7036816303 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
| X | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities | ||
| X | 261QD1600X |
Clinic/Center Specialization: Developmental Disabilities |
Ambulatory Health Care Facilities | ||
| X | 261QE0002X |
Clinic/Center Specialization: Emergency Care |
Ambulatory Health Care Facilities | ||
| X | 261QF0050X |
Clinic/Center Specialization: Family Planning, Non-Surgical |
Ambulatory Health Care Facilities | ||
| X | 261QH0100X |
Clinic/Center Specialization: Health Service |
Ambulatory Health Care Facilities | ||
| X | 261QH0700X |
Clinic/Center Specialization: Hearing and Speech |
Ambulatory Health Care Facilities | ||
| X | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| X | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities | ||
| X | 261QM1101X |
Clinic/Center Specialization: Military and U.S. Coast Guard Ambulatory Procedure |
Ambulatory Health Care Facilities | ||
| X | 261QM1102X |
Clinic/Center Specialization: Military Outpatient Operational (Transportable) Component |
Ambulatory Health Care Facilities | ||
| X | 261QM1103X |
Clinic/Center Specialization: Military Ambulatory Procedure Visits Operational (Transportable) |
Ambulatory Health Care Facilities | ||
| X | 261QP0904X |
Clinic/Center Specialization: Public Health, Federal |
Ambulatory Health Care Facilities | ||
| X | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities | ||
| X | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
UNIT 7745 |
| City | APO |
| State | AE |
| Zip Code | 09720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962638668 | Shawn Everett Gelnett | Military Health Care Provider | Unit 7745, 86 Abw, Medical Aid Station, Apo, AE 09720-7745 | 2009-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205939113 | Joann Victoria Mitchell | Registered Nurse | 65 Mdg/sgomg, Unit 7745, Apo, AE 09720 | 2006-09-06 |
| 1205811270 | Eddrina Rickia Collins | Social Worker | 65 Mdg/sgoh, Unit 7745, Apo, AE 09720 | 2005-12-13 |
| 1083038350 | Sandra Moore | Occupational Therapist | Psc 76 Box 263, 65th Med Group/sgh, Apo, AE 09720-0003 | 2014-02-07 |
| 1326454075 | Henry Phi Hoang | Pharmacist | Lajes Field 65 Mdg / Sgsd, Unit 7745, Apo, AE 09720-7745 | 2014-07-02 |
| 1285982702 | Brenda Kay Foster | Pharmacist | Lajes Field 65 Mdg/sdsg, Unit 7745, Apo, AE 09720-7745 | 2012-08-15 |
| 1497020499 | Michael Santino Luna | Dentist | Lajes Field 65 Mdg/sgod, Unit 7745, Apo, AE 09720-7745 | 2012-03-09 |
| 1003137647 | Joshua C Storey | Family Medicine | Lajes Field 65 Mdg/sgok, Apo, AE 09720-7745 | 2010-06-17 |
| 1821295528 | John Mark Kitsteiner | Family Medicine | Lajes Field 65 Mdg/sgop, Unit 7745, Apo, AE 09720-7745 | 2007-06-27 |
| 1386634137 | Kelly J Luna | Physical Therapist | Psc 76 Box 7745, Lajes Field 65 Mdg, Apo, AE 09720-7745 | 2005-10-24 |
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881888436 | Cynthia Louise Bell | Clinic/Center | Unit 21414 Box 3530, Apo, AE 09705 | 2007-08-28 |
| 1912964230 | United States Army Nurse Corps | Clinic/Center | Shape Hcf Unit 21414 Box 169, Apo, AE 09705 | 2006-04-28 |
| 1063642668 | Brian Allgood Community Hospital | Clinic/Center | 121 Combat Support Hospital, Unit 15244, Apo, AP 96205 | 2009-07-17 |
| 1528200102 | Robin Lorraine Harvel | Clinic/Center | Cmr 402, Apo, AE 09180 | 2009-03-30 |
| 1417063488 | Us Army | Clinic/Center | Usameddac Wuerzburg, Bamberg Health Clinic, Unit 27528, Apo, AE 09139 | 2006-08-22 |
Please comment or provide details below to improve the information on 65 MEDICAL GROUP.
| 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.