KIMBROUGH ACC MILITARY MTF (NPI# 1558566216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558566216 |
| Entity Type | Organization |
| Organization Name | KIMBROUGH ACC MILITARY MTF |
| Other Organization Name | USADC FT. BELVOIR LOGAN |
| Practice Address |
9515 Hall Rd Building 1099 Fort Belvoir VA 22060-5529 |
| Mailing Address |
2480 Llewellyn Ave Cdr Usameddac Mcxr-bd Ste 5800 Fort Meade MD 20755-7081 |
| Practice Telephone | 7038060002 |
| Mailing Telephone | 3016778253 |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2012-12-18 |
| Authorized Official Name | TERRI KIMBROW (UBO MANAGER) |
| Authorized Official Telephone | 3016778512 |
| Is Organization Subpart | Y |
| Parent Organization Name | KIMBROUGH ACC MILITARY MTF |
| 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 |
|---|---|
| USADC FT. BELVOIR LOGAN | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639667736 | Kimbrough Acc Military Mtf | Pharmacy | G-avenue, Bldg 400 Dept of Pharmacy, New Cumberland, PA 17070 | 2018-04-25 |
| 1457849556 | Kimbrough Acc Military Mtf | Pharmacy | Ft Indiantown Gap, Bldg 4-114, Annville, PA 17003 | 2018-04-25 |
| 1801206685 | Kimbrough Acc Military Mtf | Pharmacy | 2799 Rose Street, Ft Meade, MD 20755 | 2014-05-02 |
| 1871709576 | Kimbrough Acc Military Mtf | Clinic/Center | 99 G Street, Bldg 400, New Cumberland, PA 17070 | 2007-05-16 |
| 1417163114 | Kimbrough Acc Military Mtf | Clinic/Center | 1999 Fisher Ave, Fort Indiantown Gap, Annville, PA 17003 | 2007-05-16 |
| 1235345935 | Kimbrough Acc Military Mtf | Clinic/Center | Letterkenny Army Depot, Bldg 332, Chambersburg, PA 17201 | 2007-05-16 |
| 1689888455 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 103 3rd Ave, Building 58, Washington, DC 20319-5058 | 2007-05-10 |
| 1992108633 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 450 Gibner Rd, Carlisle, PA 17013-5090 | 2014-10-08 |
| 1205242310 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 1434 Porter St, Frederick, MD 21702-9254 | 2014-07-09 |
| 1316353782 | Kimbrough Acc Military Mtf | Pharmacy | 401 Carpenter Rd Bldg 525, Fort Myer, VA 22211-1009 | 2014-07-07 |
| Street Address |
9515 HALL RD BUILDING 1099 |
| City | FORT BELVOIR |
| State | VA |
| Zip Code | 22060-5529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790762490 | Dominique Michel Reynders | Dentist | 9515 Hall Rd, Building 1099, Fort Belvoir, VA 22060-5529 | 2005-12-23 |
| 1750351177 | Priscilla Hope Hamilton | Dentist | 9515 Hall Rd, Building 1099, Fort Belvoir, VA 22060-5529 | 2006-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447780317 | Elizabeth Joy Bier | Family Medicine | Fort Belvoir Community Hospital 9300 Dewitt Loop, Fort Belvoir, VA 22060 | 2017-06-14 |
| 1518413723 | Meredith Rae Cuddy | Social Worker | 9300 Dewitt Loop, Rivers Pavillion, 2nd Floor, Room R2.403, Fort Belvoir, VA 22060 | 2016-08-28 |
| 1760804041 | Edward Burke | Nurse Anesthetist, Certified Registered | 9300 Dewitt Loop, Sunrise Pavilion, 3rd Flr, Rm 218, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060 | 2014-01-06 |
| 1972940450 | Deepa Ramanathan Elion | Clinical Neuropsychologist | 5908 9th Street, Building 1259, Intrepid Sprit One, Nicoe, Fort Belvoir, VA 22060 | 2013-05-24 |
| 1861837643 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 8651 John J Kingman, Building 2321, Fort Belvoir, VA 22060 | 2013-05-07 |
| 1609150820 | Brittany Rodriguez | Physical Therapist | 9300 Belvoir Rd, Fort Belvoir, VA 22060 | 2011-10-06 |
| 1457657983 | Jacob Macgregor | Nurse Anesthetist, Certified Registered | 9300 Dewit Loop, Fort Belvoir Community Hospital, Fort Belvoir, VA 22060 | 2011-02-01 |
| 1518291442 | Stacie Erin Thomas | Speech-Language Pathologist | 5980 9th Street, Intrepid Pavillion, Fort Belvoir, VA 22060 | 2009-09-24 |
| 1033347125 | David Michael Hanrahan | Psychiatry & Neurology | 5980 9th Street Building #1259, Fort Belvoir Intrepid Pavillion, Fort Belvoir, VA 22060 | 2009-06-26 |
| 1649459777 | Central Care Inc | Military Hospital | 9501 Farrell Rd Bldg 805, Dewitt Health Care Center, Ft Belvoir, VA 22060 | 2007-10-25 |
| Find all providers in zip 22060 | ||||
| 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 |
|---|---|---|---|---|
| 1396026423 | Fort Belvoir Community Hospital | Clinic/Center | 9300 Dewitt Loop, Dental Clinic, Fort Belvoir, VA 22060 | 2011-09-02 |
| 1265505747 | Fort Belvoir Community Hospital | Clinic/Center | 9300 Dewitt Loop, Fort Belvoir, VA 22060-5901 | 2006-11-15 |
| 1285609800 | Dewitt Army Community Hospital | Clinic/Center | 9501 Farrell Rd, Fort Belvoir, VA 22060-5901 | 2006-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215218342 | Kenner Army Health Clinic | Clinic/Center | 8204 Ave C, Fort Lee, VA 23801-1716 | 2011-09-02 |
| 1801043252 | Kenner Ahc | Clinic/Center | 14115 Montague Rd, Fort A P Hill, VA 22427-3115 | 2008-08-27 |
| 1598958308 | Branch Medical Clinic The Basic School | Clinic/Center | 24008 Mcb #2, Quantico, VA 22134 | 2007-08-24 |
| 1821281908 | Branch Medical Clinic Ocs Brown Field | Clinic/Center | 2189 Elrod Ave, Building 5003, Quantico, VA 22134-5113 | 2007-08-22 |
| 1447457197 | Branch Medical Clinic Dahlgren | Clinic/Center | 192 Cassee Road, Bldg 192, Dahlgren, VA 22448-5000 | 2007-06-27 |
| 1821294729 | Mcdonald Army Health Center | Clinic/Center | Building 82 Ingals, Fort Monroe, VA 23651 | 2007-06-26 |
| 1659577534 | Mcdonald Army Health Center | Clinic/Center | Building 576 Stemberg Avenue, Fort Eustis, VA 23604 | 2007-06-26 |
| 1508062779 | Mcdonald Army Health Center | Clinic/Center | Building 669 Monroe Avenue, Fort Eustis, VA 23604 | 2007-06-25 |
| 1356426894 | United States Coast Guard | Clinic/Center | End of Route 238, Yorktown, VA 23690-5000 | 2006-10-25 |
| 1922199066 | Mcdonald Army Health Center | Clinic/Center | 579 Jefferson Ave, Fort Eustis, VA 23604 | 2006-09-27 |
| Find all providers with the same taxonomy | ||||
| City | FORT BELVOIR |
| Zip Code | 22060 |
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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.