BRANCH MEDICAL CLINIC DAM NECK (NPI# 1740326545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740326545 |
| Entity Type | Organization |
| Organization Name | BRANCH MEDICAL CLINIC DAM NECK |
| Practice Address |
620 John Paul Jones Cir Portsmouth VA 23708-2111 |
| Mailing Address |
1885 Terrier Ave Virginia Beach VA 23461-2205 |
| Practice Telephone | 7579535297 |
| Mailing Telephone | 7573147200 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2017-11-13 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL MEDICAL CENTER PORTSMOUTH |
| 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 |
620 JOHN PAUL JONES CIR |
| City | PORTSMOUTH |
| State | VA |
| Zip Code | 23708-2111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054840 | Debra Tooke Crowell | Registered Nurse | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2005-06-21 |
| 1659970424 | Jennifer T Birchwale | Student in an Organized Health Care Education/Training Program | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-10-22 |
| 1861091985 | Carin Kimberly Teeters | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-10-20 |
| 1275130825 | Dartangion Pierre Walker | Dental Hygienist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-10-07 |
| 1750996054 | Kevin Wilfong | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-09-14 |
| 1598379901 | Paula Shepard | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-09-02 |
| 1578177234 | Rebekah Gunter | Psychologist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-09-01 |
| 1225641863 | Dylan Quoc-chuong Vu | Dentist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-08-24 |
| 1467060111 | Ili Yuan | Dentist | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-07-20 |
| 1750909172 | Marsades Ceasar | Social Worker | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2020-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932724754 | William Dowling | Student in an Organized Health Care Education/Training Program | 260 John Paul Jones Circle, Fpo, AA 23708 | 2020-06-09 |
| 1760003156 | Kylie Miller | Student in an Organized Health Care Education/Training Program | 600 John Paul Jones Circle, Portsmouth, VA 23708 | 2020-04-27 |
| 1750900304 | Jonathan David Hickman | Student in an Organized Health Care Education/Training Program | Nmcp 620 John Paul Jones Cir., Bldg 3, Portsmouth, VA 23708 | 2020-04-14 |
| 1447716550 | Nathan Le Holterman | Student in an Organized Health Care Education/Training Program | Navy Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA 23708 | 2019-02-13 |
| 1467930545 | Jonathan Volland | Dentist | Naval Medical Center - 620 John Paul Jones Cr, Portsmouth, VA 23708 | 2018-08-01 |
| 1629570171 | Brendan James O'shea | Student in an Organized Health Care Education/Training Program | 690 John Paul Jones Circle, Fpo, AA 23708 | 2018-03-01 |
| 1467909077 | Patricia Hicks Smith | Nurse Practitioner | 620 John Paul Jones Blvd., Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2016-09-01 |
| 1790139392 | Lauren Pitters | Student in an Organized Health Care Education/Training Program | 620 John Paul Jones Circle Drive, Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2016-04-20 |
| 1841683745 | Karrie Anne Brondell Walker | Student in an Organized Health Care Education/Training Program | 620 John Paul Jones, Naval Medical Center Portsmouth, Portsmouth, VA 23708 | 2015-03-17 |
| 1962821967 | Jody Manners | Psychiatry & Neurology | 620 John Paul Jones Cir # 2e, Portsmouth, VA 23708 | 2014-04-08 |
| Find all providers in zip 23708 | ||||
| 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 |
|---|---|---|---|---|
| 1275581415 | Branch Medical Clinic Portsmouth | Clinic/Center | 1 Ayers Circle Bldg. H-1, Portsmouth Naval Shipyard, Portsmouth, NH 03804-5000 | 2006-05-04 |
| 1821135658 | Branch Medical Clinic Naval Shipyard Norfolk | Clinic/Center | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2007-01-31 |
| 1881730265 | Branch Medical Clinic Yorktown | Clinic/Center | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2007-01-30 |
| 1629114004 | Branch Medical Clinic Oceana | Clinic/Center | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2007-01-30 |
| 1407992894 | Branch Medical Clinic Sewells Point | Clinic/Center | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2007-01-30 |
| 1861538258 | Tricare Medical Clinic Chesapeake | Clinic/Center | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2007-01-30 |
| 1558407734 | Branch Medical Clinic Little Creek | Clinic/Center | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2007-01-29 |
| 1518003797 | Tricare Medical Clinic Virginia Beach | Clinic/Center | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2007-01-29 |
| 1528104494 | Branch Medical Clinic Chesapeake | Clinic/Center | 620 John Paul Jones Cir, Portsmouth, VA 23708-2111 | 2007-01-29 |
| 1417007790 | Isc Portsmouth Health Services Division Uscg | Clinic/Center | 4000 Coast Guard Blvd, Portsmouth, VA 23703-2199 | 2007-01-11 |
| Find all providers in PORTSMOUTH | ||||
| City | PORTSMOUTH |
| Zip Code | 23708 |
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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.