EVANS ARMY COMMUNITY HOSPITAL (NPI# 1770826968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770826968 |
| Entity Type | Organization |
| Organization Name | EVANS ARMY COMMUNITY HOSPITAL |
| Other Organization Name | EBH TEAM 1-FT. CARSON |
| Practice Address |
Bldg 2649 Specker Ave Ft Carson CO 80913 |
| Mailing Address |
1650 Cochrane Cir Attn Third Party Office Ft Carson CO 80913-4613 |
| Practice Telephone | 7195267000 |
| Mailing Telephone | 7195037045 |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2015-05-08 |
| Authorized Official Name | ELIZABETH BURLINGAME (UBO MANAGER) |
| Authorized Official Telephone | 7195267291 |
| Is Organization Subpart | Y |
| Parent Organization Name | EVANS ARMY COMMUNITY HOSPITAL |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PARENT FACILITY NPI | 1497795702 | 01 |
| Other Name | Type Code |
|---|---|
| EBH TEAM 1-FT. CARSON | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639689904 | Evans Army Community Hospital | Pharmacy | 565 Space Center Dr Ste 130, Colorado Springs, CO 80915-3610 | 2017-10-02 |
| 1467895318 | Evans Army Community Hospital | Clinic/Center | Bldg 2361 Titus Blvd, Ft Carson, CO 80913 | 2013-04-10 |
| 1912340894 | Evans Army Community Hospital | Clinic/Center | Building 1226 Felkins St, Ft Carson, CO 80913 | 2013-04-10 |
| 1558704429 | Evans Army Community Hospital | Clinic/Center | Building 1657 Barkley Ave, Ft Carson, CO 80913 | 2013-04-10 |
| 1376986240 | Evans Army Community Hospital | Clinic/Center | Building 9481 Wilderness Rd, Ft Carson, CO 80913 | 2013-04-10 |
| 1841568169 | Evans Army Community Hospital | Military Hospital | 2400 Cody Dr, Colorado Springs, CO 80911-1018 | 2011-12-01 |
| 1447565528 | Evans Army Community Hospital | Clinic/Center | 7503 Cochrane Cir, Usadc-2, Ft Carson, CO 80913-4603 | 2010-08-12 |
| 1861623936 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 3220 Union Blvd, Colorado Springs, CO 80907-4900 | 2009-08-06 |
| 1124221619 | Evans Army Community Hospital | Clinic/Center | 2356 Quinn Street, Fort Carson, CO 80913 | 2007-06-11 |
| 1215130703 | Evans Army Community Hospital | Clinic/Center | 1227 Felkins Street, Fort Carson, CO 80913 | 2007-06-11 |
| Street Address |
BLDG 2649 SPECKER AVE |
| City | FT CARSON |
| State | CO |
| Zip Code | 80913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326651498 | Christopher M Juneau | Physical Therapist | Us Air Force/ Fort Carson, 8420 Skyraider Rd, Colorado Springs, AA 80913 | 2020-08-28 |
| 1003433640 | Denise Marie Cacho | Dentist | Smith Dental Clinic, 2280 Hogan St. Blgd 1561, Fort Carson, CO 80913 | 2020-06-30 |
| 1497378053 | Ivan Sergeyevich Koutsopatriy | Dentist | Us Army Dental Health Activity 1667 Cochrane Circle, Bldg 7495, Fort Carson, CO 80913 | 2020-05-18 |
| 1396293478 | Kayla Howerton | Audiologist | 8901 Wetzel Ave, Bldg 1525, Fort Carson, CO 80913 | 2016-09-16 |
| 1922472125 | Danell Pugh | Social Worker | Bldg 1657, Fort Carson, CO 80913 | 2015-11-25 |
| 1750761136 | Colin Michael Kenny | Internal Medicine | Evans Army Community Hospital. 1650 Cochrane Cir B7500, Fort Carson, CO 80913 | 2015-06-01 |
| 1740689736 | Rachel Edwards | Speech-Language Pathologist | Evans Community Hospital, 1650 Cochrane Circle, Fort Carson, CO 80913 | 2014-08-15 |
| 1841617859 | Douglas Foote | Social Worker | 1657 Prussman, Ft. Carson, CO 80913 | 2014-03-27 |
| 1649619396 | Brigette Marie Grimes | Dietitian, Registered | Building 1435, 4th Infantry Division, Division Surgeon, Fort Carson, CO 80913 | 2013-06-17 |
| 1467895318 | Evans Army Community Hospital | Clinic/Center | Bldg 2361 Titus Blvd, Ft Carson, CO 80913 | 2013-04-10 |
| Find all providers in zip 80913 | ||||
| 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 |
|---|---|---|---|---|
| 1467895318 | Evans Army Community Hospital | Clinic/Center | Bldg 2361 Titus Blvd, Ft Carson, CO 80913 | 2013-04-10 |
| 1912340894 | Evans Army Community Hospital | Clinic/Center | Building 1226 Felkins St, Ft Carson, CO 80913 | 2013-04-10 |
| 1558704429 | Evans Army Community Hospital | Clinic/Center | Building 1657 Barkley Ave, Ft Carson, CO 80913 | 2013-04-10 |
| 1376986240 | Evans Army Community Hospital | Clinic/Center | Building 9481 Wilderness Rd, Ft Carson, CO 80913 | 2013-04-10 |
| 1447565528 | Evans Army Community Hospital | Clinic/Center | 7503 Cochrane Cir, Usadc-2, Ft Carson, CO 80913-4603 | 2010-08-12 |
| 1497795702 | Evans Army Community Hospital | Clinic/Center | 1650 Cochrane Cir Bldg 7500, Attn: Treasurer's Office, Ft Carson, CO 80913-4603 | 2006-06-07 |
| 1508101155 | Evans Army Community Hospital | Clinic/Center | 6541 Specker Ave, Bldg 1830, Ft Carson, CO 80913-4263 | 2012-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124221619 | Evans Army Community Hospital | Clinic/Center | 2356 Quinn Street, Fort Carson, CO 80913 | 2007-06-11 |
| 1215130703 | Evans Army Community Hospital | Clinic/Center | 1227 Felkins Street, Fort Carson, CO 80913 | 2007-06-11 |
| 1134322993 | Evans Army Community Hospital | Clinic/Center | 2280 Hogan St, Fort Carson, CO 80913-4408 | 2007-06-08 |
| 1336355056 | Evans Army Community Hospital | Clinic/Center | 6911 Titus Blvd, Bldg 2353 Warrior Family Medicine Clinic, Fort Carson, CO 80913-4429 | 2007-05-16 |
| 1225309644 | Evans Army Community Hospital | Clinic/Center | 565 Space Center Dr, Suite 130, Colorado Springs, CO 80915-3609 | 2012-01-17 |
| 1639305543 | Evans Army Community Hospital | Clinic/Center | 3920 N Union Blvd, Colorado Springs, CO 80907-4907 | 2009-06-05 |
| 1548464621 | Evans Army Community Hospital | Clinic/Center | 1650 Cochrane Cir, Colorado Springs, CO 80913-4603 | 2007-06-13 |
| 1245446962 | Evans Army Community Hospital | Clinic/Center | 1650 Cochrane Cir, Tmc 8, Fort Carson, CO 80913-4603 | 2007-05-16 |
| 1669686754 | Evans Army Community Hospital | Clinic/Center | 45825 E State Highway 96, Pueblo, CO 81006-9330 | 2007-05-09 |
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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.