BRANCH MEDICAL CLINIC MERIDIAN (NPI# 1609076033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609076033 |
| Entity Type | Organization |
| Organization Name | BRANCH MEDICAL CLINIC MERIDIAN |
| Practice Address |
1801 Fuller Rd Meridian MS 39309-5106 |
| Mailing Address |
6000 W Highway 98 Pensacola FL 32512-0001 |
| Practice Telephone | 6016792225 |
| Mailing Telephone | 8505056309 |
| Mailing Fax Number | 8505056908 |
| Enumeration Date | 2007-07-24 |
| Last Update Date | 2017-11-06 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL PENSACOLA |
| 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 |
| Street Address |
1801 FULLER RD |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39309-5106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972583664 | Rowland Eugene Mccoy | Dentist | 1801 Fuller Rd, Bldg 367, Meridian, MS 39309-5106 | 2006-01-19 |
| 1851592067 | Montoya Demont Gunn | Military Health Care Provider | 1801 Fuller Rd, Suite A-01, Meridian, MS 39309-5106 | 2007-05-29 |
| 1720144652 | Earl Gastador Bercide | Military Health Care Provider | 1801 Fuller Rd, Meridian, MS 39309-5107 | 2006-12-28 |
| 1033294533 | Christopher Robert Sharpe | Physician Assistant | 1801 Fuller Rd, Meridian, MS 39309-5106 | 2006-10-25 |
| 1154414191 | Steven M. Piper | General Practice | 1801 Fuller Rd, Meridian, MS 39309-5106 | 2006-10-02 |
| 1700983558 | Naval Hospital Pensacola | Pharmacy | 1801 Fuller Rd, Bldg 367 Ste A01, Meridian, MS 39309-5107 | 2006-09-20 |
| 1265463095 | Milli M Floyd | Pharmacist | 1801 Fuller Rd, Meridian, MS 39309-5106 | 2006-07-06 |
| 1790755684 | Robert James Wishmeyer | Physician Assistant | 1801 Fuller Rd, Meridian, MS 39309-5106 | 2006-01-24 |
| 1669442786 | James Eugene Clark | Dentist | 1801 Fuller Rd, Suite D-18, Meridian, MS 39309-5106 | 2006-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528038296 | Johnny Lee Cosby | Optometrist | 1801 Fuller Rd Ste A01, Meridian, MS 39309 | 2006-01-25 |
| 1093863433 | Angeles L Ballou | Nurse Practitioner | Nbhc Nas Meridian, 1801 Fuller Road Bldg 367, Meridian, MS 39309-0001 | 2007-01-08 |
| 1194705665 | Bonnie Roberts Chavez | Psychologist | Naval Branch Health Clinic, 1801 Fuller Rd. Suite A-01 Bldg 367, Meridian, MS 39309-0001 | 2006-01-19 |
| 1861472748 | Karlyna L. D. Andersen | Family Medicine | Naval Branch Health Clinic, 1801 Fuller Rd. Suite A-01 Bldg 367, Meridian, MS 39309-0001 | 2006-01-18 |
| 1477533255 | Craig Morgenstern | Family Medicine | Naval Branch Health Clinic, 1801 Fuller Road, Suite A-01, Bldg 367, Meridian, MS 39309-0001 | 2006-01-18 |
| 1568545556 | Angela Mcdonald | Nurse Practitioner | Nbhc Meridian 1801 Fuller St Bldg 367, Meridian, MS 39309-3107 | 2006-10-23 |
| 1265843155 | Patricia Everette | Social Worker | 1155 Rosenbaum Ave, Building 405, Naval Air Station, Meridian, MS 39309-5062 | 2014-05-13 |
| 1245210269 | Ann Louise Lagreco | Dentist | Naval Branch Health Clinic, 1801 Fuller Rd Ste A-01, Meridian, MS 39309-5106 | 2006-01-17 |
| 1972917060 | Naval Hospital Pensacola | Military/U.S. Coast Guard Pharmacy | 367 Fuller Rd Ste A-15, Meridian, MS 39309-5408 | 2014-06-17 |
| 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 |
|---|---|---|---|---|
| 1750584363 | Eisenhower Army Medical Center | Clinic/Center | 1450 14th St, Hattiesburg, MS 39407-0001 | 2007-06-10 |
| 1104031194 | Eisenhower Army Medical Center | Clinic/Center | 1001 Hardy St, Hattiesburg, MS 39401-4165 | 2007-05-11 |
| 1275733644 | Branch Medical Clinic Gulfport | Clinic/Center | 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2007-07-23 |
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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.