10TH MEDICAL GROUP (NPI# 1780657239) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780657239 |
| Entity Type | Organization |
| Organization Name | 10TH MEDICAL GROUP |
| Other Organization Name | USAFA MTF |
| Practice Address |
4102 Pinion Dr 10 Mdss Sgsb Usaf Academy CO 80840-2502 |
| Practice Telephone | 7193335648 |
| Practice Fax Number | 7193335202 |
| Mailing Telephone | 7193335648 |
| Mailing Fax Number | 7193335202 |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2016-04-29 |
| Authorized Official Name | JODY LYNN RIDDER (AIR FORCE UNIFORM BUSINESS OFFICE) |
| Authorized Official Telephone | 7036816384 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 286500000X | Military Hospital | Hospitals | ||
| N | 332000000X | Military/U.S. Coast Guard Pharmacy | Suppliers | ||
| N | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities | ||
| Y | 261QM1101X |
Clinic/Center Specialization: Military and U.S. Coast Guard Ambulatory Procedure |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | NCPDP | 0616536 | 01 |
| Other Name | Type Code |
|---|---|
| USAFA MTF | Other Name - Individual/Organization |
| Street Address |
4102 PINION DR 10 MDSS SGSB |
| City | USAF ACADEMY |
| State | CO |
| Zip Code | 80840-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336776467 | Rebecca Briones | Student in an Organized Health Care Education/Training Program | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2020-03-26 |
| 1588222129 | Christopher J Drager | Physical Therapist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2019-05-29 |
| 1346706454 | Hannah M Szilagy | Physical Therapist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2019-02-13 |
| 1831671262 | Alexander Ortiz | Physician Assistant | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-09-01 |
| 1336629096 | Kim D Tran | Family Medicine | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-08-21 |
| 1235624065 | Lauren Yurish-crittenden | Psychologist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-06-25 |
| 1477055572 | Keeley Katrein | Physician Assistant | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-03-05 |
| 1588162176 | Justin James Fleming | Physical Therapy Assistant | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2018-01-29 |
| 1609392570 | Mark Eulenstein | Dentist | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2017-08-22 |
| 1306387436 | Carrie Marie Ferguson | Nurse Practitioner | 4102 Pinion Dr, Usaf Academy, CO 80840-2502 | 2017-03-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114554011 | Christina Dang | Student in an Organized Health Care Education/Training Program | 4355-b Faculty Drive, Us Air Force Academy, CO 80840 | 2020-03-23 |
| 1053893123 | Glen William Myers | Dentist | 2355-b Faculty Dr, Usaf Academy, Colorado, Usafa, AA 80840 | 2018-09-05 |
| 1225374499 | National Vision Optical | Technician/Technologist | Bldg 5136, Community Center Dr., Us Air Force Academy, CO 80840 | 2012-12-17 |
| 1366758906 | Brett Michael Germain | Dentist | 2355-b Faculty Dr., Usaf Academy, CO 80840 | 2010-08-20 |
| 1518289115 | Renee Jean Cole | Military Health Care Provider | 4515 East Juniper Dr Unit A, Usaf Academy, CO 80840 | 2010-02-23 |
| 1063655140 | Gregory S. Brooks | Military Health Care Provider | 2355 Faculty Dr Suite 1n207, 10th Amds, Usafa, CO 80840 | 2009-04-20 |
| 1801092390 | Bryant Mcneill | Internal Medicine | 4102 Pinion 10mdg, Usaf Academy, CO 80840 | 2007-06-22 |
| 1447384383 | Francis Crosby Jr. | Physician Assistant | 4102 Pinon Drive, Usaf Academy, CO 80840 | 2007-03-15 |
| 1023115870 | Evans Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 5136 Eagle Dr, Ste 102, Usaf Academy, CO 80840 | 2006-09-20 |
| 1669582722 | Scott Layle Carbaugh | Physician Assistant | 4102 Pinion Dirve, Usaf Academy, CO 80840 | 2006-08-30 |
| Find all providers in zip 80840 | ||||
| Taxonomy Code | 261QM1101X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military and U.S. Coast Guard Ambulatory Procedure |
| That part of a "fixed" (non-temporary, non-deployed) DoD or Coast Guard entity furnishing surgical procedures requiring medically supervised recovery. Similar to a civilian ambulatory surgical center. May be in shared resources with a DoD or Coast Guard Clinic or a DoD Hospital. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. Includes initial "take home" pharmaceuticals. |
| 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 |
|---|---|---|---|---|
| 1942286224 | 21st Medical Group | Clinic/Center | 559 Vincent St, Peterson Afb, CO 80914-1541 | 2005-12-19 |
| 1174507420 | Military Treatment Facility | Clinic/Center | 275 S Aspen St, Stop 89, Aurora, CO 80011-9562 | 2005-11-30 |
| City | USAF ACADEMY |
| Zip Code | 80840 |
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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.