BRANCH MEDICAL CLINIC ALBANY (NPI# 1952816811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952816811 |
| Entity Type | Organization |
| Organization Name | BRANCH MEDICAL CLINIC ALBANY |
| Practice Address |
814 Radford Blvd Bldg 7000 Albany GA 31704-1130 |
| Mailing Address |
2080 Child St Jacksonville FL 32214-5005 |
| Practice Telephone | 9045466212 |
| Enumeration Date | 2017-12-13 |
| Last Update Date | 2017-12-13 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL JACKSONVILLE |
| 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 |
| Street Address |
814 RADFORD BLVD BLDG 7000 |
| City | ALBANY |
| State | GA |
| Zip Code | 31704-1130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508045550 | Hubert Williams | Military Health Care Provider | 814 Radford Blvd Bldg 7000, Albany, GA 31704-9998 | 2007-10-26 |
| 1992212112 | Laketa Clyde Williams | Social Worker | 814 Radford Blvd Bldg 7000, Albany, GA 31704-1130 | 2018-01-09 |
| 1437561214 | Branch Medical Clinic Albany Pharmacy | Military/U.S. Coast Guard Pharmacy | 814 Radford Blvd Bldg 7000, Marine Corps Logistics Base, Albany, GA 31704-1130 | 2014-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033639752 | Ryan Charles Romer | Military Health Care Provider | 814 Radford Blvd Ste 20328, Albany, GA 31704-1130 | 2017-06-23 |
| 1740269166 | Chidiebere Uzoma Ekenna-kalu | Optometrist | 814 Radford Blvd, Bldg 7000, Albany, GA 31704-1130 | 2006-01-13 |
| 1952761959 | John David Pascual | Military Health Care Provider | 814 Radford Blvd, Bldg 7000, Albany, GA 31704-1130 | 2016-03-03 |
| 1598064289 | Marine Corps Logistics Base Albany, Ga | Ambulance | 814 Radford Blvd, Suite 20346, Albany, GA 31704-1130 | 2011-03-21 |
| 1245416585 | Ryan Edward Sanford | Military Health Care Provider | 814 Radford Blvd, 20328, Albany, GA 31704-1130 | 2008-01-17 |
| 1588845762 | James Reginald Wyche | Military Health Care Provider | 814 Radford Blvd, Suite 20328, Albany, GA 31704-1130 | 2007-11-16 |
| 1952591034 | Patricia Montgomery | Nurse Practitioner | 814 Radford Blvd, Albany, GA 31704-1130 | 2007-07-26 |
| 1316997026 | Dublin Vamc | Clinic/Center | 814 Radford Blvd, Albany, GA 31704-1130 | 2006-05-11 |
| 1831160225 | Christopher Alexander Stewart | Dentist | 814 Radford Blvd, Bldg 7000, Albany, GA 31704-1130 | 2006-02-01 |
| 1053665018 | Barbara M Robinson | Pharmacist | 814 Radford Blvd, Building 7000, Albany, GA 31704-4021 | 2012-10-30 |
| Find all providers in zip 31704 | ||||
| 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 |
|---|---|---|---|---|
| 1275929770 | Winn-thrid Party Insurance | Clinic/Center | 952 William H. Wilson Ave, Fort Stewart, GA 31314 | 2015-04-10 |
| 1528454022 | Winn-thrid Party Insurance | Clinic/Center | 1746 William H. Wilson Ave, Fort Stewart, GA 31314 | 2015-04-10 |
| 1235442328 | Winn-thrid Party Insurance | Clinic/Center | 2451a Hwy 17, Station Shopping Center, Richmond Hill, GA 31324-6422 | 2010-07-19 |
| 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 |
| 1417151788 | Winn-thrid Party Insurance | Clinic/Center | 306 Vanguard Road, Building 2115, Suite 100, Fort Stewart, GA 31314 | 2007-06-12 |
| 1588868848 | Eisenhower Army Medical Center | Clinic/Center | 320 Hospital Road, Fort Gordon, GA 30905 | 2007-06-12 |
| 1235333592 | Winn-thrid Party Insurance | Clinic/Center | 434 Vanguard Road, Fort Stewart, GA 31314 | 2007-06-12 |
| 1245434448 | Martin Army Community Hospital | Clinic/Center | 2622 Soldiers Plaza, Fort Benning, GA 31905 | 2007-06-12 |
| 1912101270 | Winn-thrid Party Insurance | Clinic/Center | 55 Pony Soldier Road, Building 253-s, Fort Stewart, GA 31314 | 2007-06-12 |
| Find all providers with the same taxonomy | ||||
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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.