BASSETT ARMY COMMUNITY HOSPITAL (NPI# 1164635728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164635728 |
| Entity Type | Organization |
| Organization Name | BASSETT ARMY COMMUNITY HOSPITAL |
| Other Organization Name | TMC RICHARDSON |
| Practice Address |
724 Postal Service Loop Stop 7499 Fort Richardson AK 99505-7499 |
| Mailing Address |
1060 Gaffney Rd Stop 7420 Attn Mcuc-pad-tpc Ft Wainwright AK 99703-5007 |
| Practice Telephone | 9073615172 |
| Mailing Telephone | 9073615948 |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2015-04-08 |
| Authorized Official Name | TIMOTHY SPENCER (UBO MANAGER) |
| Authorized Official Telephone | 9073615948 |
| Is Organization Subpart | Y |
| Parent Organization Name | BASSETT 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 NCPDP/NPI2 | 0202351/1053418806 | 01 | |
| MEDCO | AN2598588 | 01 | |
| SUBPART NCPDP/NPI2 | 0202387/1497854558 | 01 | |
| PARENT NPI 2 | 1699877993 | 01 |
| Other Name | Type Code |
|---|---|
| TMC RICHARDSON | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679721864 | Bassett Army Community Hospital | Clinic/Center | 4066 Spruce St, Ft Wainwright, AK 99703-7400 | 2008-09-03 |
| 1295983591 | Bassett Army Community Hospital | Clinic/Center | 661 Arctic Road, Ft. Greely, AK 99731 | 2008-08-29 |
| 1427217447 | Bassett Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 131dg 661 Artic Ave, Fr Greely, AK 99731 | 2008-06-05 |
| 1871796615 | Bassett Army Community Hospital | Clinic/Center | 1060 Gaffney Rd Stop 7500, Mcds-dd-hos, Fort Wainwright, AK 99703-5002 | 2007-06-08 |
| 1831392679 | Bassett Army Community Hospital | Clinic/Center | 724 Postal Service Loop Stop 7500, Mcds-dd-r, Fort Richardson, AK 99505-7500 | 2007-06-08 |
| 1053418806 | Bassett Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 1060 Gaffney Rd Stop 7420, Bldg 4065, Ft Wainwright, AK 99703-5007 | 2006-09-20 |
| 1699877993 | Bassett Army Community Hospital | Clinic/Center | 1060 Gaffney Rd # 7420, Ft Wainwright, AK 99703-7420 | 2006-09-05 |
| 1295149383 | Bassett Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bassett Army Community Hospital, Meddac-alaska 1060 Gaffney Rd #7400, Ft. Wainwright, AK 99703-7400 | 2014-06-17 |
| 1427206630 | Bassett Army Community Hospital | Clinic/Center | 3406 Alder Ave, Ft Wainwright, AK 99703 | 2008-08-29 |
| 1730383886 | Bassett Army Community Hospital | Clinic/Center | 3406 Alder Ave, Mcds-dd-tdc, Ft Wainwright, AK 99703-5002 | 2007-06-13 |
| Street Address |
724 POSTAL SERVICE LOOP STOP 7499 |
| City | FORT RICHARDSON |
| State | AK |
| Zip Code | 99505-7499 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558991257 | Janice Fulton | Registered Nurse | 724 Postal Service Loop Stop 7499, Fort Richardson, AK 99505-7499 | 2020-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134763378 | Idris Usman | Social Worker | 786 D St., Jber-richardson, AK 99505 | 2019-10-31 |
| 1114578572 | Matthew Coddington | Physical Therapist | Jber Soldier Centered Medical Home, Building 786, D Street, Jber, AK 99505 | 2019-09-26 |
| 1801362132 | Jolene Danielle Sletten | Audiologist | Soldier Centered Medical Home-u.s. Army, 786 D Street, Joint Base Elemendorf-richardson, AK 99505 | 2018-10-14 |
| 1700322773 | Joshua Hatch | Physician Assistant | Bldg 786 D St., Jber, AK 99505 | 2017-01-13 |
| 1578912598 | Jacob Shook | Family Medicine | Medac 7860, Joint Base Elmendorf Richardson, AK 99505 | 2016-06-09 |
| 1699130963 | Tracy Mumbulo | Licensed Practical Nurse | 208 Akutan Ave Unit A, Jber, AK 99505 | 2015-12-30 |
| 1609294933 | Benjamin E. Thompson | Physician Assistant | Jber Scmh, Bldg 786 D St, Jber, AK 99505 | 2014-04-03 |
| 1679990279 | Daniel Lord | Psychologist | 600 Richardson Drive Community Center, Fort Richardson, Anchorage, AK 99505 | 2014-03-21 |
| 1598199028 | Nina Rodriguez | General Practice | 786 D St, Jber, AK 99505 | 2013-09-03 |
| 1720383185 | Nicole Levaillant | Psychologist | Building 786 D Street, Anchorage, AK 99505 | 2011-01-17 |
| Find all providers in zip 99505 | ||||
| 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 |
|---|---|---|---|---|
| 1831392679 | Bassett Army Community Hospital | Clinic/Center | 724 Postal Service Loop Stop 7500, Mcds-dd-r, Fort Richardson, AK 99505-7500 | 2007-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033517206 | United States Coast Guard | Clinic/Center | Base Kodiak Building N-46, Kodiak, AK 99619 | 2014-12-19 |
| 1679721864 | Bassett Army Community Hospital | Clinic/Center | 4066 Spruce St, Ft Wainwright, AK 99703-7400 | 2008-09-03 |
| 1295983591 | Bassett Army Community Hospital | Clinic/Center | 661 Arctic Road, Ft. Greely, AK 99731 | 2008-08-29 |
| 1871796615 | Bassett Army Community Hospital | Clinic/Center | 1060 Gaffney Rd Stop 7500, Mcds-dd-hos, Fort Wainwright, AK 99703-5002 | 2007-06-08 |
| 1699877993 | Bassett Army Community Hospital | Clinic/Center | 1060 Gaffney Rd # 7420, Ft Wainwright, AK 99703-7420 | 2006-09-05 |
| 1346211059 | U. S. Coast Guard | Clinic/Center | 611 Airport Dr, Sitka, AK 99835-9436 | 2006-01-30 |
| 1427206630 | Bassett Army Community Hospital | Clinic/Center | 3406 Alder Ave, Ft Wainwright, AK 99703 | 2008-08-29 |
| 1730383886 | Bassett Army Community Hospital | Clinic/Center | 3406 Alder Ave, Mcds-dd-tdc, Ft Wainwright, AK 99703-5002 | 2007-06-13 |
| 1497731590 | Isc Ketchikan-juneau Detachment | Clinic/Center | 709 W 9th St, Uscg Medical Room 627, Juneau, AK 99801-1807 | 2005-12-20 |
| City | FORT RICHARDSON |
| Zip Code | 99505 |
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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.