BROOKE ARMY MEDICAL CENTER (NPI# 1558797027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558797027 |
| Entity Type | Organization |
| Organization Name | BROOKE ARMY MEDICAL CENTER |
| Other Organization Name | CPT JENNIFER M MORENO PCC-JBSA |
| Practice Address |
3100 Schofield Rd Mche-cmh Bldg 1179 Fort Sam Houston TX 78234-7577 |
| Mailing Address |
3851 Roger Brooke Dr Mche-cou-t Dept 201 Fort Sam Houston TX 78234-4501 |
| Practice Telephone | 2108082465 |
| Mailing Telephone | 2109168558 |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2015-09-25 |
| Authorized Official Name | CLENTON BALLARD (C, UBO) |
| Authorized Official Telephone | 2109168561 |
| Is Organization Subpart | Y |
| Parent Organization Name | BROOKE ARMY MEDICAL CENTER |
| 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 |
|---|---|
| CPT JENNIFER M MORENO PCC-JBSA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710532510 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 7800 W Ih 10 Ste 235, San Antonio, TX 78230-4768 | 2019-08-08 |
| 1396119681 | Brooke Army Medical Center | Clinic/Center | 2407 N New Braunfels, Bldg 147, Ft Sam Houston, TX 78234 | 2015-11-24 |
| 1619365285 | Brooke Army Medical Center | Clinic/Center | 10010 Rogers Run, Suite 100, San Antonio, TX 78251-4403 | 2015-01-05 |
| 1831502590 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 2401 Scott Rd, Brooke Army Medical Center, Fort Sam Houston, TX 78234 | 2014-06-10 |
| 1548693526 | Brooke Army Medical Center | Clinic/Center | 5410 Mac Williams Rd, Bldg 5026 Camp Bullis, San Antonio, TX 78257 | 2013-08-14 |
| 1053618546 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 6501 Fm 3009, Suite 210, Schertz, TX 78154 | 2011-02-17 |
| 1902117187 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | 1300 Schofield Rd, Bldg 1179, San Antonio, TX 78234 | 2010-06-23 |
| 1164627121 | Brooke Army Medical Center | Clinic/Center | 1960 Stanley Rd, Blvd 2375, Fort Sam Houston, TX 78234-7650 | 2007-06-19 |
| 1073612131 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 1279, Garden Road, Ft Sam Houston, TX 78234 | 2006-09-22 |
| 1982703047 | Brooke Army Medical Center | Military/U.S. Coast Guard Pharmacy | Bldg 2401, Scott Road, Ft Sam Houston, TX 78234 | 2006-09-22 |
| Street Address |
3100 SCHOFIELD RD MCHE-CMH BLDG 1179 |
| City | FORT SAM HOUSTON |
| State | TX |
| Zip Code | 78234-7577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770578007 | Markham Jay Brown | Family Medicine | 3100 Schofield Rd, Fort Sam Houston, TX 78234-7577 | 2005-09-13 |
| 1427667872 | Jacqueline Irene Hobbs | Pharmacist | 3100 Schofield Rd, Fort Sam Houston, TX 78234-7577 | 2020-07-30 |
| 1104258292 | Negin Pahlavan | Psychologist | 3100 Schofield Rd, Fort Sam Houston, TX 78234-7577 | 2013-07-31 |
| 1487939849 | Jennifer Jean Apodaca | Physician Assistant | 3100 Schofield Rd, Building 1179, Fort Sam Houston, TX 78234-7577 | 2011-10-18 |
| 1679803001 | Osceola M Evans | Social Worker | 3100 Schofield Rd, Fort Sam Houston, TX 78234-7577 | 2010-01-07 |
| 1497089494 | Pamela Kareena Abeyta | Nurse Practitioner | 3100 Schofield Rd, Family Medicine Service, Department of The Army, Bamc, Fort Sam Houston, TX 78234-7577 | 2009-09-23 |
| 1295967818 | John A. Hudson-odoi | Nurse Practitioner | 3100 Schofield Rd, Fort Sam Houston, TX 78234-7577 | 2009-08-14 |
| 1043378276 | Cynthia Lynne Mckendrick | Nurse Practitioner | 3100 Schofield Rd, Fort Sam Houston, TX 78234-7577 | 2006-12-04 |
| 1124064324 | Patricia Wimberly | Nurse Practitioner | 3100 Schofield Rd, Blgd 1178, Fort Sam Houston, TX 78234-7577 | 2006-06-22 |
| 1982695474 | Barbara L Bowsher | Pediatrics | 3100 Schofield Rd, Bldg 1179, Fort Sam Houston, TX 78234-7577 | 2005-11-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255942884 | Thomas Ballas | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa-fort Sam Houston, Department of Behavioral Medicine-mche-dbm, San Antonio, TX 78234 | 2020-08-17 |
| 1124657366 | Wendy Harris | Pharmacist | 3041 Garden Ave, Fort Sam Houston, TX 78234 | 2020-04-08 |
| 1215564729 | Travis Frantz | Student in an Organized Health Care Education/Training Program | 3551 Rodger Brooke Drive, Jbsa Fort Sam Houston, TX 78234 | 2020-03-25 |
| 1508492695 | Matthew Grossmann | Student in an Organized Health Care Education/Training Program | San Antonio Military Medical Center, Mche-zdm-m, Internal Medicine Residency, 3551 Roger Brooke Dr., Jbsa-fort Sam Houston, TX 78234 | 2020-03-20 |
| 1235793407 | Jessica Maria May Franklin | Student in an Organized Health Care Education/Training Program | 3551 Roger Brooke Drive Jbsa Fort Sam Houston, San Antonio, TX 78234 | 2019-04-23 |
| 1730663477 | Glen Snyder | Military Health Care Provider | 3488 Garden Ave Anderson Hall, Fort Sam Houston, San Antonio, TX 78234 | 2018-09-19 |
| 1265919336 | Ashley Elizabeth Malawey | Military Health Care Provider | 3222 Cpl Johnson Road, San Antonio, TX 78234 | 2018-07-23 |
| 1053805515 | Rene Espinosa | Social Worker | San Antonio Medical Center, 3551 Roger Brooke Dr, Jbsa, TX 78234 | 2018-06-19 |
| 1235622333 | Melanie Edith Rivera | Military Health Care Provider | 3600 Roger Brooke Drive, San Antonio, TX 78234 | 2018-06-13 |
| 1063909158 | Benjamin Walker Appelo | General Practice | San Antonio Mil Med Center 3551 Roger Brooke Dr, Mche-zdm-m, San Antonio, TX 78234 | 2018-04-16 |
| Find all providers in zip 78234 | ||||
| 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 |
|---|---|---|---|---|
| 1164627121 | Brooke Army Medical Center | Clinic/Center | 1960 Stanley Rd, Blvd 2375, Fort Sam Houston, TX 78234-7650 | 2007-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326527177 | William Beaumont Army Medical Center | Clinic/Center | 11291 Sgt E Churchill St, Fort Bliss, TX 79918-8001 | 2018-08-13 |
| 1124505359 | Carl R Darnall Army Medical Center | Clinic/Center | 5200 Bunny Trail, Killeen, TX 76549 | 2018-07-20 |
| 1568948933 | Carl R Darnall Army Medical Center | Clinic/Center | 415 31st and 761st Tank Battalion, Fort Hood, TX 76544 | 2018-07-18 |
| 1740766112 | Carl R Darnall Army Medical Center | Clinic/Center | Bldg 2255 52nd and 761st Tank Battalion, Fort Hood, TX 76544 | 2018-07-18 |
| 1396119681 | Brooke Army Medical Center | Clinic/Center | 2407 N New Braunfels, Bldg 147, Ft Sam Houston, TX 78234 | 2015-11-24 |
| 1932595204 | Carl R Darnall Army Medical Center | Clinic/Center | 9410 19th St, Fort Hood, TX 76544 | 2015-04-13 |
| 1154717650 | Carl R Darnall Army Medical Center | Clinic/Center | 31002 74th Street, Fort Hood, TX 76544 | 2015-04-10 |
| 1073909578 | Carl R Darnall Army Medical Center | Clinic/Center | 37016 77th Street, Fort Hood, TX 76544 | 2015-04-10 |
| 1972999472 | Carl R Darnall Army Medical Center | Clinic/Center | 24001 Battalion Ave, 58th and 62nd Streets, Fort Hood, TX 76544 | 2015-04-10 |
| 1619365285 | Brooke Army Medical Center | Clinic/Center | 10010 Rogers Run, Suite 100, San Antonio, TX 78251-4403 | 2015-01-05 |
| Find all providers with the same taxonomy | ||||
| City | FORT SAM HOUSTON |
| Zip Code | 78234 |
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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.