HICKAM AFB 15TH MDG (NPI# 1952582009) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952582009 |
| Entity Type | Organization |
| Organization Name | HICKAM AFB 15TH MDG |
| Practice Address |
755 Scott Cir 15th Med Group Hickam Afb HI 96853-5399 |
| Practice Telephone | 8084486133 |
| Mailing Telephone | 8084486133 |
| Enumeration Date | 2007-11-16 |
| Last Update Date | 2007-11-16 |
| Authorized Official Name | MERCEDES HAMILTON (REFERRAL MANAGER) |
| Authorized Official Telephone | 8084486133 |
| Authorized Official Credential | LPN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
14816 | HI | Ambulatory Health Care Facilities |
| Street Address |
755 SCOTT CIR 15TH MED GROUP |
| City | HICKAM AFB |
| State | HI |
| Zip Code | 96853-5399 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548241276 | John Cinco | Family Medicine | 755 Scott Cir, Sgh, Hickam Afb, HI 96853-5399 | 2005-11-09 |
| 1225415235 | Sonia Evoy | Registered Nurse | 755 Scott Cir, 15th Medical Group, Hickam Afb, HI 96853-5399 | 2015-04-28 |
| 1922492537 | Tina Hairston | Dental Hygienist | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2015-03-20 |
| 1629482062 | Tripler Army Medical Center | Military/U.S. Coast Guard Pharmacy | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2014-06-13 |
| 1740626126 | Tyler Garrett | Dentist | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2013-05-13 |
| 1639300312 | Cameron Modisette | Military Health Care Provider | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2009-07-29 |
| 1669623690 | Kenneth Raymond Bellisle | Pharmacist | 755 Scott Cir, 15th Medical Group, Hickam Afb, HI 96853-5399 | 2008-10-08 |
| 1063692234 | Anthony Mark Hall | Counselor | 755 Scott Cir, Bldg 559, Hickam Afb, HI 96853-5399 | 2007-11-05 |
| 1073656856 | Woody Charles Baker | Dentist | 755 Scott Cir, 15 Mdg Sgd, Hickam Afb, HI 96853-5399 | 2007-02-14 |
| 1649379322 | Hickam Phcy | Military/U.S. Coast Guard Pharmacy | 755 Scott Cir, Hickam Afb, HI 96853-5399 | 2006-09-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467884759 | Edward Joseph Tucholski Jr. | Dentist | 15 Mdg, 755 Scott Circle, Jbphh, HI 96853 | 2013-08-08 |
| 1922232230 | Angela Marie Alveo-forbes | Military Health Care Provider | 375 Mamiya St, Bldg 2140, Hickam Ab, HI 96853 | 2009-05-14 |
| 1205180783 | John-michael Fowler | Registered Nurse | 755 Scott Circle, Jbphh, HI 96853 | 2012-11-05 |
| 1811250442 | April A Bronowski | Physical Therapist | 755 Scott Circle, 15 Mdg, Joint Base Pearl Harbor Hickam, HI 96853 | 2012-06-19 |
| 1609812163 | Joyce Ann Raszewski | Nurse Practitioner | 755 Scott Circle, Jbphh/hickam, HI 96853 | 2006-06-22 |
| 1720068976 | Richard Dale Quintana | Family Medicine | 15th Medical Group, Hickam Afb, Honolulu, HI 96853 | 2006-01-21 |
| 1124262746 | John Craig Bright | Military Health Care Provider | 15mdos/sgomf 755 Scott Circle, Hickam Afb, HI 96853-3672 | 2009-04-27 |
| 1134759715 | David Maldonado Santiago | Military Health Care Provider | 590 Moffet St, Jbphh, HI 96853-5168 | 2020-01-22 |
| 1366427395 | Lisa Katherine Rivera | Pathology | 590 Moffet St, Bldg 4077, Joint Base Pearl Harbor-hickam, Honolulu, HI 96853-5168 | 2005-12-13 |
| 1619154572 | Hickam Fire Emergency Services | Case Management | 345 Mamiya Avenue, Hickam, HI 96853-5233 | 2008-01-23 |
| Find all providers in zip 96853 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| 1497371348 | Vinson K Diep Md Inc | Clinic/Center | 1319 Punahou St Ste 1190, Honolulu, HI 96826-1089 | 2020-06-16 |
| 1891324471 | Compcare, LLC | Clinic/Center | 94-997 Hanauna St 5f, Waipahu, HI 96797 | 2020-04-05 |
| 1093348161 | Amh Series II, Hi, LLC | Clinic/Center | 415 Uluniu St Ste D, Kailua, HI 96734-2503 | 2020-02-18 |
| 1417592254 | Nancy S. Clarke, M.d. LLC | Clinic/Center | 98-211 Pali Momi St Ste 800, Aiea, HI 96701-4370 | 2019-11-15 |
| 1972071538 | Foundaton Research | Clinic/Center | 1314 S King St Ste 653, Honolulu, HI 96814-1979 | 2018-11-12 |
| 1962929398 | Mark T. Kuge,md,inc | Clinic/Center | 1481 S King St Ste 310, Honolulu, HI 96814-2684 | 2017-08-25 |
| 1346784139 | East Maui Medical Clinic, LLP | Clinic/Center | 4950 Uakea Road, Unit 2, Hana, HI 96713-0278 | 2016-12-13 |
| 1487102877 | Ka Wai Ola Medical Clinic LLC | Clinic/Center | 16-590 Old Volcano Rd, Ste. A, Keaau, HI 96749-8158 | 2016-09-14 |
| 1790230480 | Emi Ota, M.d., Inc. | Clinic/Center | 850 W Hind Dr Ste 205, Honolulu, HI 96821-1845 | 2016-08-23 |
| Find all providers with the same taxonomy | ||||
| City | HICKAM AFB |
| Zip Code | 96853 |
Please comment or provide details below to improve the information on HICKAM AFB 15TH MDG.
| 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.