BRANCH MEDICAL CLINIC MAYPORT (NPI# 1326553280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1326553280 |
Entity Type | Organization |
Organization Name | BRANCH MEDICAL CLINIC MAYPORT |
Practice Address |
2130 Mayport Rd Jacksonville FL 32233-2753 |
Mailing Address |
2080 Child St Jacksonville FL 32214-5005 |
Practice Telephone | 9042704446 |
Enumeration Date | 2017-12-13 |
Last Update Date | 2017-12-13 |
Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
Authorized Official Telephone | 2404013643 |
Is Organization Subpart | Y |
Parent Organization Name | NAVAL HOSPITAL JACKSONVILLE |
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 |
Street Address |
2130 MAYPORT RD |
City | JACKSONVILLE |
State | FL |
Zip Code | 32233-2753 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1881223469 | Ethem Gokdeniz | Private Vehicle | 2274 Fairway Villas Ln North, Atlantic Beach, FL 32233 | 2020-04-06 |
1184181000 | Jeremy Klimek | Occupational Therapist | 910 Assisi Lane, Jacksonville, FL 32233 | 2019-02-27 |
1811344385 | Kacy Lane Kreger | Speech-Language Pathologist | 2753 Shangri La Dr, Jacksonville, FL 32233 | 2016-05-15 |
1407233489 | Meghan Braun | Physical Therapist | 2159 Featherwood Drive West, Atlantic Beach, FL 32233 | 2015-04-29 |
1184979908 | Hope and A Future Ministries, Inc. | Clinic/Center | 680 Mayport Rd., Atlantic Beach, FL 32233 | 2012-07-18 |
1003171588 | Cheryl M Thacker | Massage Therapist | 531 Atlantic Boulevard, Ste 7, Atlantic Beach, FL 32233 | 2012-07-10 |
1730465451 | Jeffery Kreck | Physical Therapy Assistant | 1401 Defender Court West, Atlantic Beach, FL 32233 | 2011-10-26 |
1992977029 | Jax Rx Inc | Durable Medical Equipment & Medical Supplies | 1174 Beach Ave, Atlantic Beach, FL 32233 | 2008-03-28 |
1336368059 | Lovell L. Farris | Dentist | 10 10th St, Unit 3a, Atlantic Beach, FL 32233 | 2007-04-24 |
1033284922 | Maureen C Baxter | Nurse Practitioner | 815 Plaza, Jacksonville, FL 32233 | 2006-11-24 |
Find all providers in zip 32233 |
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 |
---|---|---|---|---|
1104331065 | Branch Medical Clinic Jacksonville | Clinic/Center | 964 Ajax St, Jacksonville, FL 32214-0001 | 2017-12-13 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588945612 | Martin Army Community Hospital | Clinic/Center | 4327 North El Salvador Way, Eglin Afb, FL 32542 | 2011-09-02 |
1871664060 | Us Navy | Clinic/Center | 340 Hulse Rd Bldg 665 Suite 105, 850-452-8051, Pensacola, FL 32508-1089 | 2006-11-11 |
1558907873 | Uscg Clinic St Petersburg | Clinic/Center | 600 8th Ave Se, St Petersburg, FL 33701-5030 | 2019-11-21 |
1053826917 | Branch Medical Clinic Key West | Clinic/Center | 1300 Douglas Cir, Key West, FL 33040-4536 | 2017-12-13 |
1760928923 | Uscg Clinic Air Station Miami | Clinic/Center | 14750 Nw 44th Ct, Opa Locka, FL 33054-2304 | 2017-01-12 |
1710206727 | Uscg Key West Clinic | Clinic/Center | 100 Trumbo Rd, Key West, FL 33040-6655 | 2010-06-01 |
1164679601 | Martin Army Community Hospital | Clinic/Center | 6069 Walkers Ln, Tmc 12 Camp Rudder, Eglin Afb, FL 32542-8505 | 2008-08-27 |
1114117173 | Branch Medical Clinic Panama City | Clinic/Center | 6703 W Highway 98, Panama City, FL 32407-7000 | 2007-07-26 |
1376733527 | Branch Medical Clinic Nattc | Clinic/Center | 760 East Ave, Pensacola, FL 32508-5140 | 2007-07-25 |
1265632616 | Branch Medical Clinic Whiting Field | Clinic/Center | 7119 Langley St, Milton, FL 32570-6105 | 2007-07-24 |
Find all providers with the same taxonomy |
City | JACKSONVILLE |
Zip Code | 32233 |
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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.