EISENHOWER ARMY MEDICAL CENTER (NPI# 1225184088) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225184088 |
| Entity Type | Organization |
| Organization Name | EISENHOWER ARMY MEDICAL CENTER |
| Practice Address |
300 W Hospital Road Eisenhower Army Medical Center Credentials Fort Gordon GA 30905-5650 |
| Mailing Address |
300 W Hospital Road Eisenhower Army Medical Center Fort Gordon GA 30905-5650 |
| Practice Telephone | 7067872720 |
| Practice Fax Number | 7067878176 |
| Mailing Telephone | 7067872720 |
| Mailing Fax Number | 7067878176 |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | YVONNE LOVENIA TUCKER-HARRIS (CHIEF, SOCIAL WORK SERVICE) |
| Authorized Official Telephone | 7067876624 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 286500000X | Military Hospital | 12359 | TX | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548672173 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Rodriguez Army Health Clinic (rahc), Bldg 21 Chrisman Rd., Fort Buchanan, PR 00934-3400 | 2014-06-02 |
| 1053661173 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Building 21, 21 Chrisman Rd, Ft Buchanan, PR 00934-3400 | 2012-09-17 |
| 1588868848 | Eisenhower Army Medical Center | Clinic/Center | 320 Hospital Road, Fort Gordon, GA 30905 | 2007-06-12 |
| 1396949657 | Eisenhower Army Medical Center | Clinic/Center | Building 25501, Brainard Avenue, Fort Gordon, GA 30905 | 2007-06-12 |
| 1619170198 | Eisenhower Army Medical Center | Clinic/Center | 1701 Hardee Avenue, S.w., Fort Mcpherson, GA 30330 | 2007-06-11 |
| 1750584363 | Eisenhower Army Medical Center | Clinic/Center | 1450 14th St, Hattiesburg, MS 39407-0001 | 2007-06-10 |
| 1104031194 | Eisenhower Army Medical Center | Clinic/Center | 1001 Hardy St, Hattiesburg, MS 39401-4165 | 2007-05-11 |
| 1346302494 | Eisenhower Army Medical Center | Military Hospital | 3395 Highland Park Pl, Memphis, TN 38111-4744 | 2006-12-15 |
| 1427131432 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | 29709 B Street, Fort Gordon, GA 30905-5741 | 2006-10-23 |
| 1104925361 | Eisenhower Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 21, Ft Buchanan, PR 00934 | 2006-09-22 |
| Street Address |
300 W HOSPITAL ROAD EISENHOWER ARMY MEDICAL CENTER CREDENTIALS |
| City | FORT GORDON |
| State | GA |
| Zip Code | 30905-5650 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790733517 | Shima Shaikh Syed | Internal Medicine | 300 W Hospital Road, Attn Credentials, Fort Gordon, GA 30905-5650 | 2006-05-04 |
| 1831365865 | Gregory Bryant Coleman | Physical Therapy Assistant | 300 W Hospital Road, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, GA 30905-5650 | 2008-04-30 |
| 1508031550 | Clarice Dewitt Marty | Physical Therapy Assistant | 300 W Hospital Road, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, GA 30905-5650 | 2008-04-29 |
| 1629243118 | Catherine Denise Ferguson | Licensed Practical Nurse | 300 W Hospital Road, Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650 | 2008-04-25 |
| 1548302573 | Yvonne Lovenia Tucker-harris | Social Worker | 300 W Hospital Road, Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650 | 2007-02-13 |
| 1760534408 | Jennifer A Welder | Registered Nurse | 300 W Hospital Road, Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650 | 2007-01-16 |
| 1659428423 | Signe Alexis Erne | Physician Assistant | 300 W Hospital Road, Od Eisenhower Army Medical Center, Fort Gordon, GA 30905-5650 | 2007-01-04 |
| 1669539094 | Vivian A. Kelley | Nurse Practitioner | 300 W Hospital Road, Eisenhower Army Medical Center Attn Credentials, Fort Gordon, GA 30905-5650 | 2007-01-03 |
| 1003978529 | Eric Larson Doane | Family Medicine | 300 W Hospital Road, Eisenhower Army Medical Center, Attn Credentials, Fort Gordon, GA 30905-5650 | 2006-12-14 |
| 1427117100 | Robert Joseph Kazragis Jr. | Internal Medicine | 300 W Hospital Road, Eisenhower Army Medical Center, Attn- Credentials, Fort Gordon, GA 30905-5650 | 2006-12-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417508995 | Priscilla Denise Brown | Prosthetic/Orthotic Supplier | 38200 3rd Ave, Fort Gordon, GA 30905 | 2019-09-25 |
| 1740754308 | Patricia Lynn Blevins | Nurse Practitioner | 300 E Hospital Dr, Augusta, GA 30905 | 2019-01-17 |
| 1861971335 | Isabella Anderson | Dentist | Usa Dental Activity, Hospital Dental Clinic, Bldg 38801 Academic, Ste B&c, Ft Gordon, GA 30905 | 2018-08-07 |
| 1972097426 | Cortney Wolfley | Student in an Organized Health Care Education/Training Program | Orthopaedics Ddeamc, 300 East Hospital Road, Fort Gordon, GA 30905 | 2018-06-19 |
| 1003337536 | David Jonathon Sabovich | Dentist | 38801 Academic Dr Ste B&cactivity, Suite B & C, Ft Gordon, GA 30905 | 2017-07-06 |
| 1437689411 | Marcos Aranda | Student in an Organized Health Care Education/Training Program | General Surgery, Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2017-06-13 |
| 1659809846 | Brian Kevin Burke | Student in an Organized Health Care Education/Training Program | 300 East Hosptial Road, Fort Gordon, GA 30905 | 2017-06-01 |
| 1902334469 | Jacqueline Renee Mulhall | Student in an Organized Health Care Education/Training Program | Ddeamc, 300 E Hospital Rd, General Surgery, Fort Gordon, GA 30905 | 2017-05-30 |
| 1750837456 | Amanda R Bailey | Internal Medicine | 300 E. Hospital Dr., Fort Gordon, GA 30905 | 2016-09-01 |
| 1689120016 | Thomas S Moffitt | Internal Medicine | Im, Dwight D Eisenhower Army Medical Center, 300 East Hospital Road, Fort Gordon, GA 30905 | 2016-08-26 |
| Find all providers in zip 30905 | ||||
| Taxonomy Code | 286500000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| A health care facility operated by the Department of Defense. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629357934 | United States Army | Military Hospital | 300 W Hospital Rd Rm 7a-46, Fort Gordon, GA 30905-5741 | 2011-08-04 |
| 1306399043 | Trevor Wesley Tobin | Military Hospital | 300 E Hospital Rd, Fort Gordon, GA 30905 | 2016-07-29 |
| 1225465511 | Dwight D Eisenhower Medical Center | Military Hospital | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2013-10-01 |
| 1497002240 | Tania I. Didas | Military Hospital | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2012-08-11 |
| 1033425897 | Dwight D. Eisenhower Hospital, Fort Gordon | Military Hospital | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2010-08-30 |
| 1740446905 | Ddeamc | Military Hospital | 300 W Hospital Rd, Fort Gordon, GA 30905-5741 | 2008-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154241 | Department of Veteran Affairs | Military Hospital | 1122 Providence Way, Lawrenceville, GA 30046-3316 | 2016-10-11 |
| 1417307190 | Sanghyub Lee | Military Hospital | 411 E 9th St # 74, Fort Stewart, GA 31314-5036 | 2016-06-14 |
| 1770956252 | Clara Mccomb | Military Hospital | 6600 Van Aalst Blvd., Fort Benning, GA 31905 | 2015-11-05 |
| 1790113348 | Veronica Garrett | Military Hospital | 804 Rosemont Pkwy, Roswell, GA 30076-4934 | 2013-10-17 |
| 1780942664 | Martin Army Community Hospital | Military Hospital | 8830 Watkins Ave, Fort Benning, GA 31905-5529 | 2012-04-27 |
| 1093947780 | Army | Military Hospital | 202 Vineyard Way, Apt. 601, Evans, GA 30809 | 2009-08-14 |
| 1497953012 | Va Medical Center | Military Hospital | 1401 Post Oak Dr Apt F, Clarkston, GA 30021-3145 | 2007-07-05 |
| 1609806504 | Va Medical Center | Military Hospital | 940 Capella Creek Way, Grayson, GA 30017-1578 | 2006-07-04 |
| 1508312711 | Martin Army Community Hospital | Military Hospital | Martin Army Community Hospital, 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2016-08-28 |
| 1508312869 | Debbie Speed-simmons | Military Hospital | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2016-08-28 |
| Find all providers with the same taxonomy | ||||
| City | FORT GORDON |
| Zip Code | 30905 |
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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.