MARTIN ARMY COMMUNITY HOSPITAL (NPI# 1891999090) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891999090 |
| Entity Type | Organization |
| Organization Name | MARTIN ARMY COMMUNITY HOSPITAL |
| Other Organization Name | USADC FT. BENNING SALOMON |
| Practice Address |
3255 Sand Hill, 11th Abn Div Rd Fort Benning GA 31905 |
| Mailing Address |
6600 Van Aalst Blvd Bldg 9250 Attn Mcxb-pp Fort Benning GA 31905-2102 |
| Practice Telephone | 7065449071 |
| Mailing Telephone | 7624082273 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-10-05 |
| Authorized Official Name | KERTREDIA DAVIS (UBO MANAGER) |
| Authorized Official Telephone | 7624080007 |
| Authorized Official Credential | MS, CRCR, CHLIS |
| Is Organization Subpart | Y |
| Parent Organization Name | MARTIN 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 |
| Other Name | Type Code |
|---|---|
| USADC FT. BENNING SALOMON | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023378403 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1100 Brookstone Centre Pkwy Rm 128, Columbus, GA 31904-4577 | 2012-05-21 |
| 1780942664 | Martin Army Community Hospital | Military Hospital | 8830 Watkins Ave, Fort Benning, GA 31905-5529 | 2012-04-27 |
| 1588945612 | Martin Army Community Hospital | Clinic/Center | 4327 North El Salvador Way, Eglin Afb, FL 32542 | 2011-09-02 |
| 1992009401 | Martin Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 6998 Old Cusseta Rd Bldg 4202, Fort Benning, GA 31905-5431 | 2010-12-28 |
| 1053624130 | Martin Army Community Hospital | Clinic/Center | 6976 Old Cusseta Rd, Harmony Church, Fort Benning, GA 31905-5431 | 2010-07-19 |
| 1902128077 | Martin Army Community Hospital | Clinic/Center | 7191 Kanopsky Ave, Bldg. #2625, Fort Benning, GA 31905-4540 | 2010-02-17 |
| 1063616266 | Martin Army Community Hospital | Clinic/Center | 9200 Mame Road, Fort Benning, GA 31905 | 2007-06-12 |
| 1245434448 | Martin Army Community Hospital | Clinic/Center | 2622 Soldiers Plaza, Fort Benning, GA 31905 | 2007-06-12 |
| 1083818280 | Martin Army Community Hospital | Clinic/Center | 2828 Sightseeing Road, Fort Benning, GA 31905 | 2007-06-12 |
| 1972707172 | Martin Army Community Hospital | Clinic/Center | 3020 Sand Hill, 11th Airborne Division Road, Fort Benning, GA 31905 | 2007-06-12 |
| Street Address |
3255 SAND HILL, 11TH ABN DIV RD |
| City | FORT BENNING |
| State | GA |
| Zip Code | 31905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134741366 | Micah Elizabeth Lajoie | Specialist/Technologist | 7148 2nd Cavalry Street, Ft. Benning, GA 31905 | 2020-05-11 |
| 1598301384 | Tiffany Nicole Wolfe | Physical Therapist | 7446 Sightseeing Road, Bldg 2515, Ft Benning, GA 31905 | 2019-11-27 |
| 1790261022 | Kyle Joseph Burkardt | Dentist | Love Dental Clinic, 7101 Hoff St, Bldg 9240, Apo, AA 31905 | 2018-07-19 |
| 1821514449 | Rebekah Schott | Dentist | 7101 Hoff St., Fort Benning, GA 31905 | 2017-08-15 |
| 1043757677 | Karen Tolliver | Dental Hygienist | 7770 Sightseeing Rd, Bldg 2828, Fort Benning, GA 31905 | 2017-01-20 |
| 1356897953 | Katelyn Dolezal | Student in an Organized Health Care Education/Training Program | 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2016-09-01 |
| 1043663636 | Vicky J. Nehl | Dental Hygienist | 11th Abn Div Rd, Bldg 3255, Fort Benning, GA 31905 | 2016-07-19 |
| 1376992719 | Xenia Key | Dental Assistant | 7770 Sightseeing Road, Bernheim Dental Clinic, Fort Benning, GA 31905 | 2016-06-07 |
| 1588013189 | Barbara Parker | Dental Assistant | 2828 Sightseeing Rd, Fort Benning, GA 31905 | 2016-06-06 |
| 1568811255 | Tavonna Ashley | Dental Hygienist | 7107 Hoff Street, Apo, AA 31905 | 2016-06-03 |
| Find all providers in zip 31905 | ||||
| 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 |
|---|---|---|---|---|
| 1053624130 | Martin Army Community Hospital | Clinic/Center | 6976 Old Cusseta Rd, Harmony Church, Fort Benning, GA 31905-5431 | 2010-07-19 |
| 1063616266 | Martin Army Community Hospital | Clinic/Center | 9200 Mame Road, Fort Benning, GA 31905 | 2007-06-12 |
| 1245434448 | Martin Army Community Hospital | Clinic/Center | 2622 Soldiers Plaza, Fort Benning, GA 31905 | 2007-06-12 |
| 1083818280 | Martin Army Community Hospital | Clinic/Center | 2828 Sightseeing Road, Fort Benning, GA 31905 | 2007-06-12 |
| 1972707172 | Martin Army Community Hospital | Clinic/Center | 3020 Sand Hill, 11th Airborne Division Road, Fort Benning, GA 31905 | 2007-06-12 |
| 1831305275 | Martin Army Community Hospital | Clinic/Center | 3216 11th Airborne Division Road, Tmc 5 Bldg 3216, Fort Benning, GA 31905-5647 | 2007-05-15 |
| 1740496181 | Martin Army Community Hospital | Clinic/Center | 5303 3rd Infantry Division Rd Bldg 3010, Fort Benning, GA 31905-5012 | 2007-05-15 |
| 1568678902 | Martin Army Community Hospital | Clinic/Center | Bldg 3415 23rd Infantry Regiment Street, Tmc 7, Fort Benning, GA 31905-5647 | 2007-05-15 |
| 1194730846 | Martin Army Community Hospital | Clinic/Center | 6600 Van Aalst Blvd Bldg 9250, Fort Benning, GA 31905-2102 | 2006-07-30 |
| 1699065565 | Martin Army Community Hospital | Clinic/Center | 6976 Old Cusseta Rd, Harmony Church Dental Clinic, Fort Benning, GA 31905-5431 | 2011-04-13 |
| Find all providers in FORT BENNING | ||||
| City | FORT BENNING |
| Zip Code | 31905 |
Please comment or provide details below to improve the information on MARTIN ARMY COMMUNITY HOSPITAL.
| 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.