KIMBROUGH ACC MILITARY MTF (NPI# 1558566125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558566125 |
| Entity Type | Organization |
| Organization Name | KIMBROUGH ACC MILITARY MTF |
| Other Organization Name | USADC-3-MEADE |
| Practice Address |
2480 Llewellyn Ave Usadc-3 Fort Meade MD 20755-5800 |
| Mailing Address |
2480 Llewellyn Ave Cdr Usameddac Mcxr-bd Ste 5800 Fort Meade MD 20755-7081 |
| Practice Telephone | 3016778800 |
| Mailing Telephone | 3016778253 |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2015-04-01 |
| Authorized Official Name | TERRI KIMBROW (UBO MANAGER) |
| Authorized Official Telephone | 3016778512 |
| Is Organization Subpart | Y |
| Parent Organization Name | KIMBROUGH ACC MILITARY MTF |
| 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-3-MEADE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639667736 | Kimbrough Acc Military Mtf | Pharmacy | G-avenue, Bldg 400 Dept of Pharmacy, New Cumberland, PA 17070 | 2018-04-25 |
| 1457849556 | Kimbrough Acc Military Mtf | Pharmacy | Ft Indiantown Gap, Bldg 4-114, Annville, PA 17003 | 2018-04-25 |
| 1801206685 | Kimbrough Acc Military Mtf | Pharmacy | 2799 Rose Street, Ft Meade, MD 20755 | 2014-05-02 |
| 1871709576 | Kimbrough Acc Military Mtf | Clinic/Center | 99 G Street, Bldg 400, New Cumberland, PA 17070 | 2007-05-16 |
| 1417163114 | Kimbrough Acc Military Mtf | Clinic/Center | 1999 Fisher Ave, Fort Indiantown Gap, Annville, PA 17003 | 2007-05-16 |
| 1235345935 | Kimbrough Acc Military Mtf | Clinic/Center | Letterkenny Army Depot, Bldg 332, Chambersburg, PA 17201 | 2007-05-16 |
| 1689888455 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 103 3rd Ave, Building 58, Washington, DC 20319-5058 | 2007-05-10 |
| 1992108633 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 450 Gibner Rd, Carlisle, PA 17013-5090 | 2014-10-08 |
| 1205242310 | Kimbrough Acc Military Mtf | Military/U.S. Coast Guard Pharmacy | 1434 Porter St, Frederick, MD 21702-9254 | 2014-07-09 |
| 1316353782 | Kimbrough Acc Military Mtf | Pharmacy | 401 Carpenter Rd Bldg 525, Fort Myer, VA 22211-1009 | 2014-07-07 |
| Street Address |
2480 LLEWELLYN AVE USADC-3 |
| City | FORT MEADE |
| State | MD |
| Zip Code | 20755-5800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356802524 | Lindsay Marie Robinson | Physical Therapy Assistant | 2480 Llewellyn Ave, Fort Meade, MD 20755-7081 | 2019-03-28 |
| 1346742905 | Judy Garcia De Cubias | Occupational Therapy Assistant | 2480 Llewellyn Ave, Fort Meade, MD 20755-7081 | 2018-02-28 |
| 1760926463 | Patrice Sahvohn Scott | Social Worker | 2480 Llewellyn Ave, Ste. 5800, Fort Meade, MD 20755-7081 | 2016-12-14 |
| 1518417815 | Mikala Bruno | Physical Therapist | 2480 Llewellyn Ave, Fort Meade, MD 20755-7081 | 2016-10-11 |
| 1386091254 | Kelly Rae Turner | Physician Assistant | 2480 Llewellyn Ave, Fort Meade, MD 20755-7081 | 2016-05-19 |
| 1255735403 | Christine Ng | Pharmacist | 2480 Llewellyn Ave, Fort Meade, MD 20755-7081 | 2014-10-17 |
| 1336541978 | Ella Maria Stallings | Nurse Practitioner | 2480 Llewellyn Ave, Fort Meade, MD 20755 | 2014-09-25 |
| 1588005052 | Christine Tuong-vi Nguyen Darby | Pharmacist | 2480 Llewellyn Ave, Fort Meade, MD 20755-7081 | 2013-07-12 |
| 1285989525 | Marian G Upton | Counselor | 2480 Llewellyn Ave, Fort Meade, MD 20755-7081 | 2012-07-23 |
| 1578827325 | Tracy Viviansue Love | Dermatology | 2480 Llewellyn Ave, Fort Meade, MD 20755-7081 | 2012-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215451216 | Patrick Hoye | Dentist | 8472 Simonds Street, Epes Dental Clinic, Ft. Meade, MD 20755 | 2017-08-01 |
| 1982150561 | Martha Davis | Technician | 2553 Hartel St, Fort Meade, MD 20755 | 2016-09-01 |
| 1649725995 | Jaclyn Leith | Psychologist | 2479 5th St., Ft. Meade, MD 20755 | 2016-08-16 |
| 1548613417 | Catherine Geller | Dental Hygienist | 8476 Simonds St, Suite 5700, Fort George G. Meade, MD 20755 | 2016-07-15 |
| 1396194510 | Cristina Ribeiro | Dental Hygienist | 8476 Simond St, Suite 5700, Fort George G. Meade, MD 20755 | 2016-06-08 |
| 1508215765 | Nicole Ferris | Dental Hygienist | 8476 Simond St Ste 5700, Fort George G. Meade, MD 20755 | 2016-06-08 |
| 1487031548 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | Rose Street, Bldg 2799, Ft Meade, MD 20755 | 2015-04-28 |
| 1801206685 | Kimbrough Acc Military Mtf | Pharmacy | 2799 Rose Street, Ft Meade, MD 20755 | 2014-05-02 |
| 1578980744 | Claudia Goleburn | Psychologist | 2479 5th St, Ft Meade, MD 20755 | 2014-03-25 |
| 1093063158 | Michael Elsworth Yapp | Pharmacist | 24180 Llewellyn Avenue, Fort Meade, MD 20755 | 2012-08-21 |
| Find all providers in zip 20755 | ||||
| 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 |
|---|---|---|---|---|
| 1124223797 | Kimbrough Acc Military Mtf | Clinic/Center | 8472 Simmond St, Fort Meade, MD 20755-5700 | 2007-06-15 |
| 1164507703 | Kimbrough Acc Military Mtf | Clinic/Center | 2480 Llewellyn Ave, Fort Meade, MD 20755-5800 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841498417 | Branch Medical Clinic Indian Head | Clinic/Center | 4141 W Wilson Rd, Suite105, Indian Head, MD 20640-5162 | 2007-07-05 |
| 1033315080 | Branch Medical Clinic Bancroft Hall | Clinic/Center | 121 Blake Rd, Annapolis, MD 21402-1300 | 2007-06-26 |
| 1063959450 | Uscg Clinic Baltimore | Clinic/Center | 2401 Hawkins Point Rd, Curtis Bay, MD 21226-1797 | 2017-01-24 |
| 1043668775 | Logistics Health Incorporated | Clinic/Center | 4201 Northview Dr Ste 410, Bowie, MD 20716-2668 | 2016-06-03 |
| 1811228422 | Us Coast Guard | Clinic/Center | 2401 Hawkins Point Rd, Baltimore, MD 21226-1797 | 2010-01-21 |
| 1851622401 | Us Coast Guard Yard - Hswl Clinic | Clinic/Center | 2401 Hawkins Point Rd, Bldg 28b, Baltimore, MD 21226 | 2010-01-21 |
| 1487850541 | Branch Medical Clinic Andrews | Clinic/Center | 1 San Diego Loop, Bldg 3282, Andrews Afb, MD 20762-5518 | 2007-06-26 |
| 1316142607 | Kimbrough Acc Military Mtf | Clinic/Center | 1434 Porter St, Usadc, Fort Detrick, MD 21702-9210 | 2007-06-18 |
| 1093910374 | Kimbrough Acc Military Mtf | Clinic/Center | 4110 Austin Road, Aberdeen Proving Ground, MD 21010 | 2007-06-18 |
| 1689879926 | Kimbrough Acc Military Mtf | Clinic/Center | 2501 Oakington St, Aberdeen Proving Ground, MD 21005-5131 | 2007-06-18 |
| Find all providers with the same taxonomy | ||||
| City | FORT MEADE |
| Zip Code | 20755 |
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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.