KELLER ARMY COMMUNITY HOSPITAL (NPI# 1912006685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912006685 |
| Entity Type | Organization |
| Organization Name | KELLER ARMY COMMUNITY HOSPITAL |
| Other Organization Name | PATTERSON AHC |
| Practice Address |
Bldg. 1075 Stephenson Ave. Ft. Monmouth NJ 07703 |
| Mailing Address |
900 Washington Rd Attn Mcud-rmd-ubo West Point NY 10996-1197 |
| Practice Telephone | 8459388239 |
| Mailing Telephone | 8459388239 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2014-04-21 |
| Authorized Official Name | KENNETH TUFFY (UBO MANAGER) |
| Authorized Official Telephone | 8459388239 |
| Is Organization Subpart | Y |
| Parent Organization Name | KELLER 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 | 1528161916 | 01 |
| Other Name | Type Code |
|---|---|
| PATTERSON AHC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235334392 | Keller Army Community Hospital | Clinic/Center | 606 Cullum Road, Building 606, West Point, NY 10996 | 2007-06-19 |
| 1275747149 | Keller Army Community Hospital | Clinic/Center | 5631 Baltimore St, Fort Dix, NJ 08640-5440 | 2007-05-10 |
| 1174622542 | Keller Army Community Hospital | Pharmacy | Bldg 606, West Point, NY 10996 | 2006-09-22 |
| 1427157882 | Keller Army Community Hospital | Pharmacy | Bldg 900, West Point, NY 10996 | 2006-09-22 |
| 1912006362 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 114 Rm 175, Ft Hamilton, NY 11252 | 2006-09-22 |
| 1588763841 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 11 Hap Amold Blvd, Tobyhanna, PA 18466 | 2006-09-22 |
| 1528167970 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 18th St and Doughboy Loop Bldg 5660, Troop Medical Health Clinic, Ft Dix, NJ 08640 | 2006-09-22 |
| 1861469355 | Keller Army Community Hospital | Rehabilitation Unit | 11 Hap Arnold Blvd, Health Clinic, Tobyhanna, PA 18466-5002 | 2006-03-02 |
| 1861898942 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 114 White Ave, Brooklyn, NY 11252-9503 | 2014-11-17 |
| 1497160113 | Keller Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Keller Army Community Hospital, Building 900 900 Washington Road, West Point, NY 10996-1197 | 2014-06-23 |
| Street Address |
BLDG. 1075 STEPHENSON AVE. |
| City | FT. MONMOUTH |
| State | NJ |
| Zip Code | 07703 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790728301 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | Fort Monmouth, Building 1003, Fort Monmouth, NJ 07703 | 2006-06-13 |
| 1184691255 | Asha Vijendran Rao | Internal Medicine | Stephensen Avenue, Va Cboc Fort Monmouth, Bldg 1075, Fort Monmouth, NJ 07703 | 2006-03-07 |
| 1407833288 | Jose Gabriel Bal | Family Medicine | Stephenson Ave, Building 1075, Fort Monmouth, NJ 07703 | 2005-12-22 |
| 1972584399 | Janet Logan | Registered Nurse | 1075 Stephenson Avenue-ft. Monmouth, Eatontown, NJ 07703 | 2005-11-11 |
| 1326029810 | Kylee Verlee Plummer | Registered Nurse | 1075 Stevenson Ave, Patterson Army Health Clinic, Fort Monmouth, NJ 07703 | 2005-11-10 |
| 1740261247 | Mary Baker Weaver | Licensed Practical Nurse | Bldg 1075 Stephenson Ave Ft. Monmouth, Eatontown, NJ 07703 | 2005-11-10 |
| 1144201963 | Carla Laurie Sawyer | Registered Nurse | 1075 Stenson Ave., Eatontown, NJ 07703 | 2005-11-09 |
| 1134100977 | Krista A Killins | Registered Nurse | Patterson Army Health Clinic, Bldg 1075 Stephenson Ave-ft Monmouth, Eatontown, NJ 07703 | 2005-11-09 |
| 1629059464 | Mary Cotogno | Registered Nurse | 1075 Stephenson Ave-fort Monmouth, Eatontown, NJ 07703 | 2005-11-09 |
| 1225019060 | Kelly Correll | Registered Nurse | 1075 Stephenson Ave.- Fort Monmouth, Eatontown, NJ 07703 | 2005-11-09 |
| Find all providers in zip 07703 | ||||
| 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 |
|---|---|---|---|---|
| 1962660340 | United States Coast Guard, Air Station Atlantic City | Clinic/Center | Faa Tech Center Bldg 350, Uscg Medical Dept, Pomona, NJ 08405 | 2008-06-02 |
| 1952509812 | Branch Medical Clinic Lakehurst | Clinic/Center | Bldg 39 Landsdowne Road, Lakehurst, NJ 08733-5006 | 2007-07-03 |
| 1275747149 | Keller Army Community Hospital | Clinic/Center | 5631 Baltimore St, Fort Dix, NJ 08640-5440 | 2007-05-10 |
| 1528245271 | Uscg Clinic Cape May | Clinic/Center | 1 Munro Ave, Health Services Division, Cape May, NJ 08204-5000 | 2008-01-24 |
| 1477750990 | Branch Medical Clinic Earle | Clinic/Center | 201 State Route 34 S, Colts Neck, NJ 07722-1902 | 2007-06-28 |
| 1124223235 | Keller Army Community Hospital | Clinic/Center | 5660 Doughboy Loop, Fort Dix, NJ 08640 | 2007-06-19 |
| 1205031770 | Keller Army Community Hospital | Clinic/Center | 1075 Stephenson Ave, Usadc, Fort Monmouth, NJ 07703-1518 | 2007-06-15 |
| 1972667228 | Uscg Samuel J Call Health Services | Clinic/Center | 1 Munro Ave, Cape May, NJ 08204-5000 | 2006-12-21 |
| City | FT. MONMOUTH |
| Zip Code | 07703 |
Please comment or provide details below to improve the information on KELLER 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.