121ST CSH/BAACH (NPI# 1063618148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063618148 |
| Entity Type | Organization |
| Organization Name | 121ST CSH/BAACH |
| Other Organization Name | USADC KR CAMP CARROLL |
| Practice Address |
Unit 15662, Bldg S137 Apo AP 96260 |
| Mailing Address |
Box 316 Unit 15244 Apo AP 96205 |
| Practice Telephone | 01182279171410 |
| Mailing Telephone | 01182279171858 |
| Enumeration Date | 2007-06-25 |
| Last Update Date | 2014-01-03 |
| Authorized Official Name | CHONG MCCUE (CHIEF, UBO) |
| Authorized Official Telephone | 01182279171857 |
| Is Organization Subpart | Y |
| Parent Organization Name | 121ST CSH/BAACH |
| 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 KR CAMP CARROLL | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568660348 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 1665, Apo, AP 96205 | 2007-07-03 |
| 1811195696 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 3576, Apo, AP 96205 | 2007-07-03 |
| 1457559239 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 7005, Apo, AP 96205 | 2007-07-03 |
| 1730387515 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg S4034, Apo, AP 96205 | 2007-07-03 |
| 1306042494 | 121st Csh/baach | Clinic/Center | Unit 15658, Bldg 808, Apo, AP 96224 | 2007-06-25 |
| 1730385824 | 121st Csh/baach | Clinic/Center | Unit 15659, Bldg 220, Apo, AP 96218 | 2007-06-25 |
| 1215133301 | 121st Csh/baach | Clinic/Center | Unit 15660, Bldg 555, Apo, AP 96271 | 2007-06-25 |
| 1053517144 | 121st Csh/baach | Clinic/Center | Unit 15663, Bldg 600, Apo, AP 96297 | 2007-06-25 |
| 1700082880 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 5107, Apo, AP 96205 | 2007-06-25 |
| 1295931384 | 121st Csh/baach | Clinic/Center | Unit 15653, Bldg S306, Apo, AP 96258 | 2007-06-25 |
| Street Address |
UNIT 15662, BLDG S137 |
| City | APO |
| State | AP |
| Zip Code | 96260 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518491984 | Aaron Vanderburg | Physician Assistant | Bldg S180 American Ave, Apo, AP 96260 | 2017-04-12 |
| 1619365327 | Gabriel Valdez | Physician Assistant | Camp Carroll Medical Clinic, Unit 15375, Apo, AP 96260 | 2015-01-05 |
| 1326239559 | Michael Alan Redd | General Practice | 501 Sbde, Hhc, Unit 15476, Box 146, Apo, AP 96260 | 2007-08-05 |
| 1851679369 | Jun Sung Hong | Dentist | 618th Dental Company (as), Camp Carroll Dental Clinic, Apo, AP 96260 | 2011-08-01 |
| 1376612499 | Brian Allgood Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 263, Apo, AP 96260-0275 | 2006-11-06 |
| 1396304846 | Danielle Sprunger | Dietitian, Registered | Unit 15375, Apo, AP 96260-5375 | 2019-06-09 |
| 1700326493 | Matthew Perdue | Physician Assistant | Hhc 2id Sbde, Unit 15476, Apo, AP 96260-5476 | 2017-03-01 |
| 1306371273 | Kyle Piecora | Psychologist | Hhc 2id Sbde, Unit 15476, Box #131, Apo, AP 96260-5476 | 2017-04-27 |
| 1881667053 | Risa Maree Record | Dentist | 618 Dental Company (as), Unit #15662 Bldg. S137 Texas Avenue, Camp Carroll, APO AP 96260-5662 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871194654 | Megan Mccann | Social Worker | Hq Meddacb, Unit 28038 Bld 700, Apo, AE 09112 | 2020-11-06 |
| 1144821588 | Leona Marie Walker | Registered Nurse | Bldg. 650 Huebner Road, Fort Riley, 66442, Apo, AA 66442 | 2020-11-03 |
| 1699375360 | Erin Rosa Moore-preston | Radiology | Us Army Medical Activity- Bavaria, Unit 28038, Apo, AE 09112 | 2020-10-30 |
| 1811597578 | Desirae Leann Chitishvili | Nurse's Aide | Us Army Medical Activity-bavaria Unit 28038, Attn: Mceu-bav-cre, Apo, AE 09112 | 2020-10-30 |
| 1255931689 | Stephanie Ann Lyons | Social Worker | Psc 80 Box 608, Apo, AP 96367-9998 | 2020-10-26 |
| 1154920940 | Kyle Leo Price | Military Health Care Provider | Uss Oklahoma City, Apo, AP 96932 | 2020-10-22 |
| 1740889559 | Caitlyn Paige Parnell | Registered Nurse | Patch Barracks Illinoisstrasse 70569, Bld 2300, Apo, AE 09046 | 2020-10-22 |
| 1336747799 | John Daniel Generous | Physician Assistant | Bastogne St, Bldg 5-4257 Clark Health Clinic Fort Bragg, Apo, AA 18310 | 2020-10-16 |
| 1093312928 | Richard Keith Smith | Physical Therapist | Landstuhl Regional Medical Centr, Apo, AE 09067 | 2020-10-05 |
| 1154938520 | Jacob Steven Blackhurst | Dentist | Bldg 4-1838 Normandy Dr, Apo, AA 28307-7302 | 2020-09-29 |
| Find all providers in APO | ||||
| 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 |
|---|---|---|---|---|
| 1891982518 | Jtf-b Med El-honduras | Clinic/Center | Unit 5700, Apo, AA 34042 | 2007-09-26 |
| 1568660348 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 1665, Apo, AP 96205 | 2007-07-03 |
| 1811195696 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 3576, Apo, AP 96205 | 2007-07-03 |
| 1457559239 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 7005, Apo, AP 96205 | 2007-07-03 |
| 1730387515 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg S4034, Apo, AP 96205 | 2007-07-03 |
| 1306042494 | 121st Csh/baach | Clinic/Center | Unit 15658, Bldg 808, Apo, AP 96224 | 2007-06-25 |
| 1730385824 | 121st Csh/baach | Clinic/Center | Unit 15659, Bldg 220, Apo, AP 96218 | 2007-06-25 |
| 1215133301 | 121st Csh/baach | Clinic/Center | Unit 15660, Bldg 555, Apo, AP 96271 | 2007-06-25 |
| 1053517144 | 121st Csh/baach | Clinic/Center | Unit 15663, Bldg 600, Apo, AP 96297 | 2007-06-25 |
| 1700082880 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 5107, Apo, AP 96205 | 2007-06-25 |
| Find all providers in APO | ||||
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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.