WOMACK ARMY MEDICAL CENTER (NPI# 1871810044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871810044 |
| Entity Type | Organization |
| Organization Name | WOMACK ARMY MEDICAL CENTER |
| Other Organization Name | TROOP & FAMILY MED CL-FT. BRAG |
| Practice Address |
383 Maynard St Pope Afb NC 28308-2321 |
| Mailing Address |
2817 Reilly St Mcxc-dbo-ub Wamc Stop A Fort Bragg NC 28310-7324 |
| Practice Telephone | 9109079262 |
| Mailing Telephone | 9109076693 |
| Enumeration Date | 2010-04-28 |
| Last Update Date | 2014-04-07 |
| Authorized Official Name | BARBARA BLACK (UBO MANAGER) |
| Authorized Official Telephone | 9109078537 |
| Is Organization Subpart | Y |
| Parent Organization Name | WOMACK ARMY MEDICAL CENTER |
| 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 |
|---|---|---|---|
| BCBS UB-04 PROVIDER ID | 00539 | 01 | |
| BCBS CMS 1500 PROVIDER ID | 0294A | 01 | |
| BCBS PHARMACY ID | 0465Y | 01 | |
| PARENT NPI | 1740377423 | 01 |
| Other Name | Type Code |
|---|---|
| TROOP & FAMILY MED CL-FT. BRAG | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356907471 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 4-2817 Reilly Rd Bldg B, Fort Bragg, NC 28310-0001 | 2019-05-14 |
| 1891246708 | Womack Army Medical Center | Pharmacy | 1571 Reilly Rd, Bldg 4, Ft Bragg, NC 28307 | 2016-10-17 |
| 1861867293 | Womack Army Medical Center | Military Hospital | 2817 Reily Road, Fort Bragg, NC 28317 | 2015-12-10 |
| 1700250248 | Womack Army Medical Center | Rehabilitation Unit | 215 Ice Ave, 100, Dayton, OH 45402 | 2015-11-20 |
| 1205206935 | Womack Army Medical Center | Clinic/Center | 3908 Longstreet, Bldg 3-4303, Fort Bragg, NC 28310-0001 | 2015-10-07 |
| 1932577368 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 55 Centennial Pkwy, Cameron, NC 28326-4013 | 2015-09-02 |
| 1578951042 | Womack Army Medical Center | Clinic/Center | 55 Centennial Parkway, Cameron, NC 28326 | 2015-01-06 |
| 1801215660 | Womack Army Medical Center | Clinic/Center | 2857 Watson St, Bldg M-1704, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1710306576 | Womack Army Medical Center | Clinic/Center | Tagaytay Rd Bldg C-1624, Fort Bragg, NC 28310-7301 | 2014-04-09 |
| 1508285362 | Womack Army Medical Center | Clinic/Center | Kendenburg St Bldg H-6338, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| Street Address |
383 MAYNARD ST |
| City | POPE AFB |
| State | NC |
| Zip Code | 28308-2321 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962720599 | Womack Army Medical Center | Clinic/Center | 383 Maynard St, Dental Clinic, Pope Afb, NC 28308-2321 | 2010-05-06 |
| 1568697068 | Jessica Serpa | Military Health Care Provider | 383 Maynard St, Pope Afb, NC 28308-2321 | 2009-05-28 |
| 1710121595 | Sheila Ann Shimek Christman | Military Health Care Provider | 383 Maynard St, Bldg 307a Flight Medicine, Pope Afb, NC 28308-2321 | 2009-04-24 |
| 1801030903 | Keith Rockins | Military Health Care Provider | 383 Maynard St, 307a Flight Medicine, Pope Afb, NC 28308-2321 | 2009-04-21 |
| 1467551754 | Womack Army Medical Center | Military/U.S. Coast Guard Pharmacy | 383 Maynard St, Pope Afb, NC 28308 | 2006-09-22 |
| 1750336103 | K Rae Ambroz | Family Medicine | 383 Maynard St, Pope Afb, NC 28308-2321 | 2006-05-24 |
| 1023079944 | Stephanie Irene King | Optometrist | 383 Maynard St, Bldg 307a, Pope Afb, NC 28308-2321 | 2006-03-30 |
| 1619957586 | 43rd Medical Group | Clinic/Center | 383 Maynard St, 43rd Medical Group, Pope Afb, NC 28308-2321 | 2006-01-18 |
| 1730162306 | Fred Patrick Stone | Social Worker | 383 Maynard St, Pope Afb, NC 28308-2321 | 2005-11-28 |
| 1275516221 | Robert Delancy | Physician Assistant | 383 Maynard St, 43rd Medical Group, Pope Afb, NC 28308-2321 | 2005-11-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770138018 | William Ayers Kelly Iv | Specialist/Technologist | 1520 Hurst St, Fort Bragg, NC 28308 | 2019-08-05 |
| 1043779275 | Jeremy Scott Rodesky | Military Health Care Provider | 1526 Hurst Dr, Pope Field, AA 28308 | 2019-03-18 |
| 1285953588 | Michael Patrick Sweeney | Physician Assistant | Bldg 3050 Malvesti Drive, Pope Army Airfield, NC 28308 | 2010-05-26 |
| 1710116595 | Patrick Joseph Hunt | Military Health Care Provider | 1 Matero Dr, Ol-c 342trs, Pope, NC 28308 | 2009-07-14 |
| 1013142231 | Joshua Douglas Stephenson | Emergency Medical Technician, Paramedic | 1 Matero Drive, Pope Field, NC 28308 | 2009-05-18 |
| 1972747863 | Barry Alan Frasier | Emergency Medical Technician, Paramedic | 3-1947 Malvesti Road, Pope Afb, NC 28308 | 2009-04-23 |
| 1598844854 | Patrick Sean O'maille | Psychologist | 24 Sts, Pope Afb, Pope Afb, NC 28308 | 2006-11-06 |
| 1467463901 | John Benjamin Warburton | Student in an Organized Health Care Education/Training Program | 829 Armistead St., 43 Mdos/sgoh, Pope Afb, NC 28308 | 2006-08-10 |
| 1386639540 | Christopher Michael Collier | Dentist | 43 Mdg/sggd, 383 Maynard St., Pope Afb, NC 28308 | 2005-09-14 |
| 1932580305 | April Marie Brown | Military Health Care Provider | 1398 Surveyor St, 43 Aes, Pope Aaf, NC 28308 | 2015-06-11 |
| Find all providers in zip 28308 | ||||
| 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 |
|---|---|---|---|---|
| 1962720599 | Womack Army Medical Center | Clinic/Center | 383 Maynard St, Dental Clinic, Pope Afb, NC 28308-2321 | 2010-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205206935 | Womack Army Medical Center | Clinic/Center | 3908 Longstreet, Bldg 3-4303, Fort Bragg, NC 28310-0001 | 2015-10-07 |
| 1235508557 | United States Navy | Clinic/Center | Psc Box 20098, Hq and Service Co, 1st Bn, 6th Marine Regt, 2d Mardiv, Camp Lejeune, NC 28542-0098 | 2015-09-16 |
| 1578951042 | Womack Army Medical Center | Clinic/Center | 55 Centennial Parkway, Cameron, NC 28326 | 2015-01-06 |
| 1801215660 | Womack Army Medical Center | Clinic/Center | 2857 Watson St, Bldg M-1704, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1710306576 | Womack Army Medical Center | Clinic/Center | Tagaytay Rd Bldg C-1624, Fort Bragg, NC 28310-7301 | 2014-04-09 |
| 1508285362 | Womack Army Medical Center | Clinic/Center | Kendenburg St Bldg H-6338, Fort Bragg, NC 28310-0001 | 2014-04-09 |
| 1134433402 | Womack Army Medical Center | Clinic/Center | 2356 South Peak Drive, Hope Mills, NC 28348 | 2010-07-29 |
| 1760795769 | Womack Army Medical Center | Clinic/Center | 2350 Bentridge Ln, Woodland Bldg, Fayetteville, NC 28304-0586 | 2010-07-19 |
| 1003051210 | Us Army | Clinic/Center | 5587 Lockridge Road, Fayetteville, NC 28311 | 2008-12-03 |
| 1942495270 | Branch Medical Clinic Camp Geiger Mcb | Clinic/Center | 100 Brewster Blvd - Code 08/zd, Camp Lejeune, NC 28547-2538 | 2007-09-10 |
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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.