121ST CSH/BAACH (NPI# 1306042494) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306042494 |
| Entity Type | Organization |
| Organization Name | 121ST CSH/BAACH |
| Other Organization Name | USADC KR CAMP CASEY |
| Practice Address |
Unit 15658, Bldg 808 Apo AP 96224 |
| 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 CASEY | 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 |
| 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 |
| 1063618148 | 121st Csh/baach | Clinic/Center | Unit 15662, Bldg S137, Apo, AP 96260 | 2007-06-25 |
| Street Address |
UNIT 15658, BLDG 808 |
| City | APO |
| State | AP |
| Zip Code | 96224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134752819 | Heather Meier | Physician Assistant | Meddac K/tmc, Unit 15609, Apo, AP 96224 | 2020-02-20 |
| 1497214084 | Riley F Worwood | Physician Assistant | Hhb Btry 6-37, Unit 15410, Dongducheon, DONGDUCHEON 96224 | 2019-03-14 |
| 1538652631 | Sung Chol Kim | Physician Assistant | 210th Fa Bde, Unit # 15564, Apo, AP 96224 | 2018-06-13 |
| 1780037234 | Kenneth Edwards | Physician Assistant | 1-38 Fa Battalion, Apo, AP 96224 | 2016-07-20 |
| 1285026336 | Jason Pearce | Social Worker | Hhb 210 Fa Bde, Unit# 15564, Apo, AP 96224 | 2015-02-26 |
| 1023418043 | Tyson Dewayne Hunter | Physician Assistant | Casey Tmc, Apo, AP 96224 | 2014-08-27 |
| 1376942375 | Stephen Netherland | Physician Assistant | Hhc, 1bstb, 1abct, Unit #15046, Apo, AP 96224 | 2014-08-15 |
| 1447676796 | Jeffrey Daniel Hannah | Physician Assistant | Hhb 6-37 Unit 15410, Apo, AP 96224 | 2014-03-11 |
| 1376810051 | Adhana Mccarthy | Physician Assistant | Hhc 1bstb Pa Medics, Unit 15046, Apo, AP 96224 | 2011-11-22 |
| 1992081657 | Eric Alan Ross | Physician Assistant | Camp Casey Cinic, Meddax K/tmc Unit 15609, Apo, AP 96224 | 2011-10-26 |
| Find all providers in zip 96224 | ||||
| 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 |
| 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 |
| 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.