GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL


Address: 12720 Kansas Ave, Bldg 789, Fort Leonard Wood, MO 65473
Phone: 5735960388

GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL (NPI# 1548656044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548656044
Entity Type Organization
Organization Name GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL
Other Organization Name USADC BOAK-LEONARD WOOD
Practice Address 12720 Kansas Ave
Bldg 789
Fort Leonard Wood
MO 65473
Mailing Address 4430 Missouri Ave
Attn Mcxp Rmd Ub Box 1242
Fort Leonard Wood
MO 65473-9098
Practice Telephone 5735960388
Mailing Telephone 5735960494
Enumeration Date 2015-04-10
Last Update Date 2015-09-25
Authorized Official Name CRAIG PEEL (UBO MANAGER)
Authorized Official Telephone 5735960494
Is Organization Subpart Y
Parent Organization Name GENERAL LEONARD WOOD ARMY COMMUNITY HOSPITAL

Taxonomy

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 Provider/Organization Names

Other Name Type Code
USADC BOAK-LEONARD WOOD Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1366812091 General Leonard Wood Army Community Hospital Clinic/Center 7621 Big Piney Rd, Fort Leonard Wood, MO 65473-1572 2015-10-07
1568762110 General Leonard Wood Army Community Hospital Military Hospital 126 Missouri Ave., Fort Leonard Wood, MO 65473 2010-10-29
1942529961 General Leonard Wood Army Community Hospital Clinic/Center 194 Eastlawn Ave, Suite D, Saint Robert, MO 65584-3701 2010-06-01
1700081700 General Leonard Wood Army Community Hospital Clinic/Center West 4th and Virginia Street, Fort Leonard Wood, MO 65473 2007-06-19
1114133923 General Leonard Wood Army Community Hospital Clinic/Center 4300 Goodfellow Blvd, Goodfellow Complex Bldg 103d, Saint Louis, MO 63120-1703 2007-05-16
1033325840 General Leonard Wood Army Community Hospital Clinic/Center Alabama Avenue Bldg 885, Fort Leonard Wood, MO 65473-8952 2007-05-16
1306945738 General Leonard Wood Army Community Hospital Military/U.S. Coast Guard Pharmacy 4430 Missouri Ave Bldg 360, Fort Leonard Wood, MO 65473-9098 2006-09-22
1225083249 General Leonard Wood Army Community Hospital Clinic/Center 4430 Missouri Ave, Fort Leonard Wood, MO 65473-9098 2006-05-24
1275920076 General Leonard Wood Army Community Hospital Military/U.S. Coast Guard Pharmacy 4430 Missouri Ave, General Leonard Wood Ach, Fort Leonard Wood, MO 65473-9098 2015-04-20
1548657612 General Leonard Wood Army Community Hospital Military/U.S. Coast Guard Pharmacy 4430 Missouri Ave, Glwach Pharmacy, Fort Leonard Wood, MO 65473-9098 2015-04-16

Office Location

Street Address 12720 KANSAS AVE
BLDG 789
City FORT LEONARD WOOD
State MO
Zip Code 65473

Providers in the same location

NPI Name Taxonomy Address Enumeration
1902352743 Jill Stephanie Simono Dental Assistant 12720 Kansas Ave, Bldg 789, Fort Leonard Wood, MO 65473 2016-08-31
1851847131 Debra L Vine Dental Assistant 12720 Kansas Ave, Bldg 789, Fort Leonard Wood, MO 65473 2016-08-28

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1770192759 Clara Boo Chai Physician Assistant General Leonard Wood Army Community Hospital, 4430 Missouri Ave, #1267, Fort Leonard Wood, MO 65473 2020-07-27
1982198453 Traci Anne Shambo Dental Hygienist Bldg. 400 Virginia Ave, Fort Leonard Wood, MO 65473 2018-06-19
1083133771 Mary Joan Klemp Family Medicine Ganeral Leonard Wood Army Community Hospital, 4430 Missouri Ave; Meddac Case Management; Primary Care, Fort Leonard Wood, MO 65473 2017-09-13
1255791851 Sarah Elizabeth Joy Physician Assistant 885 West 16th Street, Fort Leonard Wood, MO 65473 2016-02-25
1548626948 Jaimie-lee Musen Physical Therapist 4430 Missouri Ave, Glwach, Fort Leonard Wood, MO 65473 2016-01-14
1609240852 Angela Carson Registered Nurse 4330 Missouri Avenue, Fort Leonard Wood, MO 65473 2015-11-25
1811379407 Katharine Leigh Stringer Dentist 12720 Kansas Avenue, Fort Leonard Wood, MO 65473 2015-06-19
1740670314 Terricka Stewart Specialist/Technologist 885 West 16th St., Fort Leonard Wood, MO 65473 2015-02-03
1427467265 Dianna Morrison Social Worker 4430 Missouri Ave Box 1278, Fort Leonard Wood, MO 65473 2014-08-06
1265848634 Rachel Lopp Specialist/Technologist Bld 901, Room 131, Fort Leonard Wood, MO 65473 2014-07-07
Find all providers in zip 65473

Taxonomy Information

Taxonomy Code 261QM1100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Military/U.S. Coast Guard Outpatient

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1366812091 General Leonard Wood Army Community Hospital Clinic/Center 7621 Big Piney Rd, Fort Leonard Wood, MO 65473-1572 2015-10-07
1700081700 General Leonard Wood Army Community Hospital Clinic/Center West 4th and Virginia Street, Fort Leonard Wood, MO 65473 2007-06-19
1033325840 General Leonard Wood Army Community Hospital Clinic/Center Alabama Avenue Bldg 885, Fort Leonard Wood, MO 65473-8952 2007-05-16
1063617272 General Leonard Wood Army Community Hospital Clinic/Center 126 Missouri Ave, Usadc, Fort Leonard Wood, MO 65473-8952 2007-06-18
1760687214 General Leonard Wood Army Community Hospital Clinic/Center 1724 Nebraska Ave, Building 1608, Fort Leonard Wood, MO 65473-8939 2007-06-15

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1952804668 Equi-librium Therapy Center Clinic/Center 1148 S Courtney Ln, Rogersville, MO 65742-4501 2018-03-09
1942529961 General Leonard Wood Army Community Hospital Clinic/Center 194 Eastlawn Ave, Suite D, Saint Robert, MO 65584-3701 2010-06-01
1114133923 General Leonard Wood Army Community Hospital Clinic/Center 4300 Goodfellow Blvd, Goodfellow Complex Bldg 103d, Saint Louis, MO 63120-1703 2007-05-16
1861605404 Munson Army Health Center Clinic/Center 15431 Andrews Rd, Kansas City, MO 64147-1221 2007-05-08

Competitor

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City FORT LEONARD WOOD
Zip Code 65473

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Dataset Information

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.

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