WALTER REED NATIONAL MILITARY MEDICAL CENTER (NPI# 1720292501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720292501 |
| Entity Type | Organization |
| Organization Name | WALTER REED NATIONAL MILITARY MEDICAL CENTER |
| Other Organization Name | DILORENZO TRICARE HEALTH CLINIC |
| Practice Address |
8901 Wisconsin Ave Psc Box 509 Code 6300 Bethesda MD 20889-5600 |
| Practice Telephone | 3012954934 |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2011-11-15 |
| Authorized Official Name | MARCIA DICKSON (FINANCIAL MGT ANALYST) |
| Authorized Official Telephone | 3012954934 |
| Is Organization Subpart | Y |
| Parent Organization Name | WALTER REED NATIONAL MILITARY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers | ||
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PHARMACY NCPDP | 0904119 | 01 | |
| PARENT FACILITY NPI EFFECTIVE 1 SEP 2011 | 1639130222 | 01 | |
| PARENT FACILITY NPI UNTIL 30 AUG 2011 | 1063441905 | 01 |
| Other Name | Type Code |
|---|---|
| DILORENZO TRICARE HEALTH CLINIC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548868870 | Walter Reed National Military Medical Center | Military/U.S. Coast Guard Pharmacy | 101 Buchanan Rd, Annapolis, MD 21402-5107 | 2020-10-09 |
| 1407194889 | Walter Reed National Military Medical Center | Military Hospital | 2000 N St Nw, Apt 503, Washington, DC 20036-2336 | 2013-01-20 |
| 1902182538 | Walter Reed National Military Medical Center | Military/U.S. Coast Guard Pharmacy | 8901 Wisconsin Ave, Bldg 9 2nd Floor, Bethesda, MD 20889-0001 | 2011-10-27 |
| 1407165053 | Walter Reed National Military Medical Center | Military Hospital | 8901 Wisconsin Ave, Psc Box 509 Code 6300, Bethesda, MD 20889-5600 | 2010-09-30 |
| 1326163544 | Walter Reed National Military Medical Center | Military Hospital | 8901 Rockville Pike, Bethesda, MD 20889-0001 | 2007-03-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | WALTER REED NATIONAL MILITARY MEDICAL CENTER | 8901 Rockville Pike, Bethesda, MD 20889-0001 |
| Street Address |
8901 WISCONSIN AVE PSC BOX 509 CODE 6300 |
| City | BETHESDA |
| State | MD |
| Zip Code | 20889-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093710246 | Rosemary Grace Carr-malone | Psychiatry & Neurology | 8901 Wisconsin Ave, Bethesda, MD 20889-5600 | 2005-06-15 |
| 1861017212 | Luke White | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-06-11 |
| 1538782545 | Alexander Pastino | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-26 |
| 1104449362 | Justin James De Vera | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-22 |
| 1881217180 | Reece Mckenzie | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-20 |
| 1073135695 | Alex Kim | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-18 |
| 1619599354 | Jacob Mickey Wyse | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-16 |
| 1770105413 | Anna M Russell | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-16 |
| 1699397364 | Jessica Nicole Clark | Student in an Organized Health Care Education/Training Program | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-15 |
| 1558983296 | Mason Cleary Ditthardt Fortuno | Military Health Care Provider | 8901 Wisconsin Ave, Bethesda, MD 20889-0004 | 2020-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457987034 | Michael Franco | Student in an Organized Health Care Education/Training Program | Internal Medicine - Walter Reed Nmmc, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2020-03-16 |
| 1245862135 | Kay Tomashek | Pediatrics | National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889 | 2020-02-07 |
| 1104470657 | Adam Pink | Dentist | 8901 Wisconsin Ave Building 9 Floor 2, Bethesda, MD 20889 | 2019-08-01 |
| 1659939155 | Matthew Heller | Student in an Organized Health Care Education/Training Program | Psychiatry Walter Reed National Military Medica, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2019-05-30 |
| 1891258034 | Jane Ann Crotteau | Student in an Organized Health Care Education/Training Program | Pediatrics Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2019-04-12 |
| 1417434341 | Andrea Baeder | Dentist | 8901 Wisconsin Ave Bldg 9, Floor 2, Bethesda, AA 20889 | 2018-07-24 |
| 1942741723 | John Vance | Orthotist | Wrnmmc Orthotics, 8901 Wisconsin Avenue, Bethesda, MD 20889 | 2017-03-14 |
| 1790225704 | Sylvia Best | Pharmacist | 8901 Wisconsin Avenue Wrnmmc-, Americas Building 19- Internal Medicine Suite 2820, Bethesda, MD 20889 | 2017-02-24 |
| 1255783767 | Ryan Kaye | Student in an Organized Health Care Education/Training Program | Nsa Bethesda, 8901 Wisconsin Ave, Bethesda, Md 20889, Fpo, AA 20889 | 2016-07-08 |
| 1366861221 | Tara Elizabeth Brown | Internal Medicine | 8901 Wisconsin Avenue Walter Reed Nmmc, Bethesda, MD 20889 | 2014-04-08 |
| Find all providers in zip 20889 | ||||
| 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] |
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| 1033315080 | Branch Medical Clinic Bancroft Hall | Clinic/Center | 121 Blake Rd, Annapolis, MD 21402-1300 | 2007-06-26 |
| 1063959450 | Uscg Clinic Baltimore | Clinic/Center | 2401 Hawkins Point Rd, Curtis Bay, MD 21226-1797 | 2017-01-24 |
| 1043668775 | Logistics Health Incorporated | Clinic/Center | 4201 Northview Dr Ste 410, Bowie, MD 20716-2668 | 2016-06-03 |
| 1811228422 | Us Coast Guard | Clinic/Center | 2401 Hawkins Point Rd, Baltimore, MD 21226-1797 | 2010-01-21 |
| 1851622401 | Us Coast Guard Yard - Hswl Clinic | Clinic/Center | 2401 Hawkins Point Rd, Bldg 28b, Baltimore, MD 21226 | 2010-01-21 |
| 1487850541 | Branch Medical Clinic Andrews | Clinic/Center | 1 San Diego Loop, Bldg 3282, Andrews Afb, MD 20762-5518 | 2007-06-26 |
| 1316142607 | Kimbrough Acc Military Mtf | Clinic/Center | 1434 Porter St, Usadc, Fort Detrick, MD 21702-9210 | 2007-06-18 |
| 1093910374 | Kimbrough Acc Military Mtf | Clinic/Center | 4110 Austin Road, Aberdeen Proving Ground, MD 21010 | 2007-06-18 |
| 1689879926 | Kimbrough Acc Military Mtf | Clinic/Center | 2501 Oakington St, Aberdeen Proving Ground, MD 21005-5131 | 2007-06-18 |
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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.