MALCOLM GROW MEDICAL CENTER (NPI# 1508917501) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508917501 |
| Entity Type | Organization |
| Organization Name | MALCOLM GROW MEDICAL CENTER |
| Practice Address |
1050 W Perimeter Rd 79mdos-sgohy Andrews Afb MD 20762-6601 |
| Practice Telephone | 2408570168 |
| Mailing Telephone | 2408570168 |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JENNA M ERMOLD (STAFF PSYCHOLOGIST) |
| Authorized Official Telephone | 2408570168 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 286500000X | Military Hospital | 0810003522 | VA | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215994660 | Malcolm Grow Medical Center | Clinic/Center | 1050 W Perimeter Rd, Mdss Sgsr, Andrews Afb, MD 20762-6600 | 2006-04-28 |
| Street Address |
1050 W PERIMETER RD 79MDOS-SGOHY |
| City | ANDREWS AFB |
| State | MD |
| Zip Code | 20762-6601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114360898 | Lori Lynn Littlejohn | Nurse Anesthetist, Certified Registered | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2013-04-11 |
| 1770838948 | Heidi Derade | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2012-07-13 |
| 1285916601 | Janet Denise Cochran | Social Worker | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2011-09-12 |
| 1699054288 | Jose Antonio Rodriguez | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2011-08-12 |
| 1497081574 | Lindsay Kate Gregus | Military Health Care Provider | 1050 W Perimeter Rd, Sgoic, Andrews Afb, MD 20762-6601 | 2009-10-26 |
| 1093049827 | Jon Burrill Geno | Nurse Practitioner | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2009-09-26 |
| 1740419084 | Christopher Clement Rhoney | Military Health Care Provider | 1050 W Perimeter Rd, 779 Mdg/sgn, Andrews Afb, MD 20762-6601 | 2009-07-08 |
| 1689800278 | Dexter Dewayne Robinson | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2009-06-09 |
| 1942444815 | Erica Marie Jasper | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2009-04-23 |
| 1760625040 | Teresa Rollins | Military Health Care Provider | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2009-04-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982210423 | Kevin Wang | Dentist | 1057 W Perimeter Rd, Prince County, MD 20762 | 2020-09-21 |
| 1306467667 | Priscilla Andalia | Student in an Organized Health Care Education/Training Program | 1065 W. Perimeter Road, Jb Andrews, MD 20762 | 2020-04-28 |
| 1275162877 | Gabi Im | Dentist | 1065 W Perimeter Rd., Joint Base Andrews, Apo, AA 20762 | 2020-04-06 |
| 1083240139 | Shirley Ye | Student in an Organized Health Care Education/Training Program | 1025 Boston Rd, Joint Base Andrews, MD 20762 | 2020-03-20 |
| 1255988853 | Songxuan Zhou Niemtzow | Acupuncturist | Acupuncture Center and Integrative Medicine Center, 1060 West Perimeter Road, Joint Base Andrews, MD 20762 | 2019-08-20 |
| 1487010971 | Tracy Ellen Ambos | Social Worker | 5100 Fetcher Avenue, Joint Base Andrews, MD 20762 | 2016-01-13 |
| 1154718450 | Ryan Mason Kring | Emergency Medicine | Malcolm Grow Medical Clinics, 1060 W Perimeter Rd, Joint Base Andrews, MD 20762 | 2015-04-24 |
| 1518206044 | Jeremy Gallman | Veterinarian | 1781 Arnold Ave., Joint Base Andrews, MD 20762 | 2013-02-04 |
| 1043556418 | Kimberly Mccoy-singh | Physical Therapist | 1075 West Perimeter Rd., 779 Mdos/sgoy, Joint Base Andrews, MD 20762 | 2012-12-12 |
| 1417215799 | Alexander Rostam Kheradi | Emergency Medicine | 1050 West Perimeter Road, Joint Base Andrews, MD 20762 | 2012-04-24 |
| Find all providers in zip 20762 | ||||
| Taxonomy Code | 286500000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| A health care facility operated by the Department of Defense. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851590608 | United States Air Force | Military Hospital | 1050 W Perimeter Rd, Andrews Afb, MD 20762-6601 | 2007-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205295193 | Salem Petros | Military Hospital | 12206 Castle Pines Dr, Beltsville, MD 20705-1146 | 2016-02-19 |
| 1275853251 | National Naval Medical Center | Military Hospital | 4400 E West Hwy Apt 1125, Bethesda, MD 20814-4513 | 2010-06-02 |
| 1326208661 | Christa M. Lewis | Military Hospital | 19419 Rayfield Dr, Germantown, MD 20874-6257 | 2008-06-10 |
| 1619011749 | Walter Reed Army Medical Center | Military Hospital | 2901 S. Leisure World Blvd. A-217, Silver Spring, MD 20906 | 2007-02-20 |
| 1164591822 | University of Texas Southwestern Medical Center | Military Hospital | National Cancer Institute Medical Oncology Branch, Building 10, Room 5a01, Bethesda, MD 20892-0001 | 2006-11-07 |
| 1730289133 | Kevin Charles Abbott | Military Hospital | 7 Rudis Way, Gaithersburg, MD 20878-1143 | 2006-09-25 |
| 1356317069 | National Naval Medical Center | Military Hospital | Professional Affairs, 8901 Wisconsin Ave, Bethesda, MD 20889-0001 | 2006-02-23 |
| 1992770879 | National Naval Medical Center | Military Hospital | 503 Robert Grant Avenue, Div Et, Walter Reed Army Institute of Research, Silver Spring, MD 20874 | 2006-02-22 |
| 1568437234 | Air Force Medical Operations Agency | Military Hospital | 525 Fraim Street, Afmoa/sgxs, Frederick, MD 21702 | 2006-02-17 |
| 1932185063 | United States Navy | Military Hospital | 6409 Trillium Trl, Glenn Dale, MD 20769-9034 | 2005-12-20 |
| Find all providers with the same taxonomy | ||||
| City | ANDREWS AFB |
| Zip Code | 20762 |
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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.