MARTIN ARMY COMMUNITY HOSPITAL (NPI# 1902128077) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902128077 |
| Entity Type | Organization |
| Organization Name | MARTIN ARMY COMMUNITY HOSPITAL |
| Practice Address |
7191 Kanopsky Ave Bldg. #2625 Fort Benning GA 31905-4540 |
| Mailing Address |
7950 Martin Loop Fort Benning GA 31905-5647 |
| Practice Telephone | 7065451661 |
| Practice Fax Number | 7065451695 |
| Enumeration Date | 2010-02-17 |
| Last Update Date | 2010-02-17 |
| Authorized Official Name | MS. ELAINE MORGAN (CREDENTIALS MANAGER) |
| Authorized Official Telephone | 7065445195 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1102X |
Clinic/Center Specialization: Military Outpatient Operational (Transportable) Component |
Ambulatory Health Care Facilities |
| 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 |
| 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 |
| 1891999090 | Martin Army Community Hospital | Clinic/Center | 3255 Sand Hill, 11th Abn Div Rd, 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 |
7191 KANOPSKY AVE BLDG. #2625 |
| City | FORT BENNING |
| State | GA |
| Zip Code | 31905-4540 |
| 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 | 261QM1102X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Military Outpatient Operational (Transportable) Component |
| "Non-fixed" facilities or distinct parts of a "non-fixed" facility, providing outpatient medical and dental services, primarily intended for DoD active duty. The entity is funded with other than Defense Health Program funding. Non-DoD active duty may receive services from this entity. "Non-fixed" facilities are generally deployed DoD health care activities, not providing services on or in association with a DoD fort or base. "Non-fixed" facilities include outpatient services furnished onboard ships. "Non-fixed" facilities also include deployed clinics. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport. |
| Notes: [1/1/2005: title modified, definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265516470 | Lawrence Joel Army Health Clinic | Clinic/Center | 1701 Hardee Ave, Ft Mcpherson, GA 30330 | 2006-10-24 |
| City | FORT BENNING |
| Zip Code | 31905 |
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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.