KENNER ARMY HEALTH CLINIC (NPI# 1164640504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164640504 |
| Entity Type | Organization |
| Organization Name | KENNER ARMY HEALTH CLINIC |
| Practice Address |
700 24th St Fort Lee VA 23801-1716 |
| Mailing Address |
11719 Walnut Wood Ct Midlothian VA 23112-3268 |
| Practice Telephone | 8047349449 |
| Practice Fax Number | 8047349053 |
| Mailing Telephone | 8045951602 |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2008-08-12 |
| Authorized Official Name | MR. JOSEPH EUGENE WATSON (LICENSED PRACTICAL NURSE) |
| Authorized Official Telephone | 8047349449 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
0002041915 | VA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215218342 | Kenner Army Health Clinic | Clinic/Center | 8204 Ave C, Fort Lee, VA 23801-1716 | 2011-09-02 |
| 1982703013 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg 3219, Ft Lee, VA 23801 | 2006-09-22 |
| 1922107044 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg P8130, Ft Lee, VA 23801 | 2006-09-22 |
| 1417361866 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | 700 24th St Bldg 8130, Kenner Army Health Clinic, Fort Lee, VA 23801-1716 | 2014-06-13 |
| 1043591175 | Kenner Army Health Clinic | Clinic/Center | 700 24th St, Bldg 3219 Ncxo Tmc, Fort Lee, VA 23801-1716 | 2011-09-02 |
| 1497036529 | Kenner Army Health Clinic | Clinic/Center | 2601 C Ave, Tmc 2 Bld T8204, Fort Lee, VA 23801-1717 | 2011-09-02 |
| 1811285034 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | 700 24th St, Kenner Army Health Clinic, Fort Lee, VA 23801-1716 | 2011-07-21 |
| 1689879330 | Kenner Army Health Clinic | Clinic/Center | 2601 C Ave, Fort Lee, VA 23801-1717 | 2007-06-20 |
| 1891854014 | Kenner Army Health Clinic | Clinic/Center | 700 24th St, Fort Lee, VA 23801-1716 | 2006-12-06 |
| 1356330641 | Kenner Army Health Clinic | Clinic/Center | 700 24th St, Fort Lee, VA 23801-1716 | 2005-10-19 |
| Street Address |
700 24TH ST |
| City | FORT LEE |
| State | VA |
| Zip Code | 23801-1716 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366448334 | Robert Stanley Brown Sr. | Psychiatry & Neurology | 700 24th St, Fort Lee, VA 23801-1716 | 2005-06-24 |
| 1306354196 | Raquel Bopp | Dietitian, Registered | 700 24th St, Fort Lee, VA 23801-1716 | 2018-01-16 |
| 1316495419 | Monica Jones | Psychologist | 700 24th St, Bldg 8130, Fort Lee, VA 23801-1716 | 2016-09-17 |
| 1316324445 | Cody J Cole | Pharmacist | 700 24th St, Fort Lee, VA 23801-1716 | 2015-04-27 |
| 1598195174 | Michael Hurst | Physical Therapist | 700 24th St, Fort Lee, VA 23801-1716 | 2013-11-19 |
| 1114355542 | Zachary Marcus Leftwich | Pharmacist | 700 24th St, Fort Lee, VA 23801-1716 | 2013-10-22 |
| 1235578857 | Elizabeth Ramona Brown | Nurse Practitioner | 700 24th St, Fort Lee, VA 23801-1716 | 2013-06-17 |
| 1881938793 | Melanee Davis | Pharmacist | 700 24th St, Fort Lee, VA 23801-1716 | 2012-11-15 |
| 1871840793 | Jasmin Isabel Filpo | Optometrist | 700 24th St, Fort Lee, VA 23801-1716 | 2012-08-09 |
| 1912264359 | Pamela Annette Mcphearson | Nurse Practitioner | 700 24th St, Fort Lee, VA 23801-1716 | 2012-04-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790262384 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | Ft. Lee 300 A Ave., Fort Lee, VA 23801 | 2018-07-26 |
| 1770812190 | Arkeye | Optometrist | 300 A Avenue, Bldg 1605, Fort Lee, VA 23801 | 2009-12-14 |
| 1992911044 | Claudis Andre' Williams Jr. | Physician Assistant | 700 24th St., Kenner Army Health Clinic, Ft. Lee, VA 23801 | 2007-05-15 |
| 1982703013 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg 3219, Ft Lee, VA 23801 | 2006-09-22 |
| 1922107044 | Kenner Army Health Clinic | Military/U.S. Coast Guard Pharmacy | Bldg P8130, Ft Lee, VA 23801 | 2006-09-22 |
| 1538135157 | Laurie Sue Giertz | Physician Assistant | 700 24th St Apt Hill, Fort Lee, VA 23801 | 2006-02-24 |
| 1689653396 | Robert Keith Lather | Emergency Medicine | Kenner Army Health Clinic, Primary Care Division, Ft Lee, VA 23801 | 2006-01-11 |
| 1265418370 | Edward Cathright Jr. | Dentist | 504 Trenton Drive, Fort Lee, VA 23801 | 2005-12-20 |
| 1801854807 | Mack Conley O'quinn Jr. | Social Worker | 700 24th Street, Kenner Army Health Clinic, Fort Lee, VA 23801 | 2006-05-02 |
| 1083690028 | Kimberly Ellen Newton | Registered Nurse | 700 24th Street, Usameddac Kahc Attn: Credentials Office, Fort Lee, VA 23801 | 2005-12-21 |
| Find all providers in zip 23801 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
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| 1912302605 | Alexandria Health Department | Clinic/Center | 1200 North Howard, Alexandria, VA 22304 | 2014-10-24 |
| 1518366707 | Stephen Scarlata | Clinic/Center | 4446 Briarwood Ct S, Annandale, VA 22003-4836 | 2014-08-14 |
| 1053677690 | Leonard S Levine | Clinic/Center | 6205 Marilyn Dr, Alexandria, VA 22310-1520 | 2012-04-09 |
| 1700110970 | Blessed and Favored Home Health Inc | Clinic/Center | 5155 Ashborough Dr, Providence Forge, VA 23140-4472 | 2009-09-21 |
| 1548493984 | Arlington Free Clinic | Clinic/Center | 2921 South 11th St, Arlington, VA 22204 | 2009-09-02 |
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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.