MADIGAN ARMY MEDICAL CTR (NPI# 1588812481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588812481 |
| Entity Type | Organization |
| Organization Name | MADIGAN ARMY MEDICAL CTR |
| Other Organization Name | USADC FT. LEWIS MCCHORD |
| Practice Address |
691 Barnes Blvd Mcchord Afb WA 98438-1303 |
| Mailing Address |
9040a Jackson Ave Attn: Mchj-csa-u Tacoma WA 98431-0001 |
| Practice Telephone | 2539684035 |
| Mailing Telephone | 2539686598 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2015-04-13 |
| Authorized Official Name | KAREN MADY (TPC MANAGER) |
| Authorized Official Telephone | 2539686598 |
| Is Organization Subpart | Y |
| Parent Organization Name | MADIGAN ARMY MEDICAL CTR |
| 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. LEWIS MCCHORD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770975583 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3749, Tacoma, WA 98431-0001 | 2015-03-03 |
| 1528488848 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | Madigan Army Medical Ctr 9040, Jackson Ave, Tacoma, WA 98431-1100 | 2014-04-25 |
| 1376974303 | Madigan Army Medical Ctr | Clinic/Center | 3 Rd Division Dr Bldg R3150, Tacoma, WA 98431-0001 | 2013-12-02 |
| 1588094213 | Madigan Army Medical Ctr | Clinic/Center | C St Bldg R1880, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1043640774 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3742, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1750719761 | Madigan Army Medical Ctr | Clinic/Center | 5 Th St Bldg 9025, Tacoma, WA 98431-0001 | 2013-10-30 |
| 1801152723 | Madigan Army Medical Ctr | Clinic/Center | 13815 8th St, Joint Base Lewis Mcchord, WA 98431-0001 | 2012-04-04 |
| 1316243744 | Madigan Army Medical Ctr | Military/U.S. Coast Guard Pharmacy | 10507 156th St E, Suite 112, Puyallup, WA 98374-9361 | 2011-02-02 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1881907822 | Madigan Army Medical Ctr | Clinic/Center | 3415 Pacific Ave Se, Suite D1, Olympia, WA 98501-2173 | 2010-07-20 |
| Street Address |
691 BARNES BLVD |
| City | MCCHORD AFB |
| State | WA |
| Zip Code | 98438-1303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578547436 | Cynthia Lee Fry-spray | Physician Assistant | 691 Barnes Blvd, Mcchord Afb, WA 98438 | 2005-12-05 |
| 1669708640 | Melissa A Reimer | Military Health Care Provider | 691 Barnes Blvd, Mcchord Afb, WA 98438-1303 | 2009-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457810483 | Roveds Kaarins | Nursing Care | Mcchord Air Force Base Clinic, 690 Barnes Blvd Jblm Lakewood Wa, Apo, AA 98438 | 2019-03-19 |
| 1326459843 | Dr Larsen Eye Care Inc | Optometrist | 504 A St Mcchord Main Exchange, Ft. Lewis Mcchord Afb, WA 98438 | 2014-05-19 |
| 1548580392 | Kevin Lok | Family Medicine | 600 Barnes Blvd., Mcchord Medical Clinic, Jblm, WA 98438 | 2010-06-03 |
| 1720205578 | Nathan Kane Fosmore | Registered Nurse | Us Dept of The Us Airforce, 690 Barnes Blvd, Mcchord Afb, WA 98438 | 2007-04-20 |
| 1225176951 | Ronald Richardson Morris | Family Medicine | 690 Barnes Road, Mcchord Medical Clinic Fam Med Clinic, Joint Base Lewis Mcchord, WA 98438 | 2007-02-02 |
| 1770527418 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | A Street Bldg 504, Mcchord Afb, WA 98438 | 2006-06-15 |
| 1982660692 | Shanti Jones | Registered Nurse | 62nd Med Group, 690 Barnes Ave, Mcchord Afb, WA 98438 | 2006-04-21 |
| 1366432171 | Robert Dean Rock | Dentist | 527 Barnes Blvd, Mcchord Air Forse Base Dental Clinic, Mcchord, WA 98438 | 2005-10-24 |
| 1457344913 | Norman Harris | Dentist | 62mdos/sgod 690 Barnes Blvd., Mcchord Afb, WA 98438 | 2005-08-30 |
| 1699196865 | Sharon Chang | Nurse Practitioner | 690 Barnes Blvd, Lewis Mcchord, WA 98438 | 2013-12-13 |
| Find all providers in zip 98438 | ||||
| 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 |
|---|---|---|---|---|
| 1609023274 | Madigan Army Medical Ctr | Clinic/Center | 690 Barnes Blvd, Mcchord Afb, WA 98438-1303 | 2008-08-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770975583 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3749, Tacoma, WA 98431-0001 | 2015-03-03 |
| 1376974303 | Madigan Army Medical Ctr | Clinic/Center | 3 Rd Division Dr Bldg R3150, Tacoma, WA 98431-0001 | 2013-12-02 |
| 1588094213 | Madigan Army Medical Ctr | Clinic/Center | C St Bldg R1880, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1043640774 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3742, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1750719761 | Madigan Army Medical Ctr | Clinic/Center | 5 Th St Bldg 9025, Tacoma, WA 98431-0001 | 2013-10-30 |
| 1801152723 | Madigan Army Medical Ctr | Clinic/Center | 13815 8th St, Joint Base Lewis Mcchord, WA 98431-0001 | 2012-04-04 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1881907822 | Madigan Army Medical Ctr | Clinic/Center | 3415 Pacific Ave Se, Suite D1, Olympia, WA 98501-2173 | 2010-07-20 |
| 1497952667 | Madigan Army Medical Ctr | Clinic/Center | Building R3125, Bennett Avenue, Fort Lewis, WA 98433 | 2007-06-29 |
| 1992902571 | Madigan Army Medical Ctr | Clinic/Center | Dc#2 Building 3740p, Fort Lewis, WA 98433 | 2007-06-28 |
| Find all providers with the same taxonomy | ||||
| City | MCCHORD AFB |
| Zip Code | 98438 |
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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.