BLANCHFIELD ARMY COMMUNITY HOSPITAL (NPI# 1659785053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659785053 |
| Entity Type | Organization |
| Organization Name | BLANCHFIELD ARMY COMMUNITY HOSPITAL |
| Other Organization Name | EBH5-FT. CAMPBELL |
| Practice Address |
Bldg 6747 A Shau Valley Road Fort Campbell KY 42223 |
| Mailing Address |
650 Joel Dr Attn Ubo Fort Campbell KY 42223-5318 |
| Practice Telephone | 2707988967 |
| Mailing Telephone | 2707988286 |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |
| Authorized Official Name | CHAD HALE (ACTING UBO MANAGER) |
| Authorized Official Telephone | 2707988286 |
| Is Organization Subpart | Y |
| Parent Organization Name | BLANCHFIELD ARMY COMMUNITY HOSPITAL |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PARENT FACILITY BLANCHFIELD ARMY COMMUNITY HOSPITAL NPI 2 | 1417044702 | 01 |
| Other Name | Type Code |
|---|---|
| EBH5-FT. CAMPBELL | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942783246 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 110 Pharm Usa Health Clinic, Rock Island, IL 61299-0001 | 2018-09-12 |
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1215340401 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 98a Michigan Ave, Fort Campbell, KY 42223-5622 | 2014-06-05 |
| 1336575497 | Blanchfield Army Community Hospital | Clinic/Center | Toccoa Road Bldg 70344, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1518393677 | Blanchfield Army Community Hospital | Clinic/Center | 53rd Street and Indiana Ave, Bldg 3929, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1427484583 | Blanchfield Army Community Hospital | Clinic/Center | 55th Street and Indiana Avenue, Bldg 3960, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1154757219 | Blanchfield Army Community Hospital | Clinic/Center | 30th Street and Desert Storm Avenue, Bldg 6988, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1376982413 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | 650 Joel Dr Bldg B, Fort Campbell, KY 42223-5318 | 2013-06-21 |
| 1457643231 | Blanchfield Army Community Hospital | Military/U.S. Coast Guard Pharmacy | Bldg 7973 Strike Blvd, Fort Campbell, KY 42223 | 2011-05-11 |
| 1770872251 | Blanchfield Army Community Hospital | Clinic/Center | 7973 Strike Blvd, Us Army Dental Clinic Adkins, Ft Campbell, KY 42223 | 2011-04-05 |
| Street Address |
BLDG 6747 A SHAU VALLEY ROAD |
| City | FORT CAMPBELL |
| State | KY |
| Zip Code | 42223 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558978825 | Eden Addisu Kebede | Social Worker | Ft. Campbell/bach, 650 Joel Drive, Fort Campbell, KY 42223 | 2020-09-30 |
| 1174134662 | Lucas Pepper | Dentist | Desert Storm Ave, Bldg 5580, Apo, AA 42223 | 2020-08-10 |
| 1639711203 | Travis Robert Bryant | Optometrist | 5979 Desert Storm Ave., Lapointe Health Clnic Optometry, Ft. Campbell, KY 42223 | 2019-10-15 |
| 1184138232 | Vanessa Renee Simmons | Dental Assistant | 302b Baker St, Fort Campbell, KY 42223 | 2017-11-28 |
| 1922451996 | Isabella Julson | Dental Assistant | Bldg2441 21st Street, Us Army Dental Activity, Fort Campbell, KY 42223 | 2016-07-14 |
| 1336595305 | Heidi Cameron | Acupuncturist | 2889b Idaho Avenue, Fort Campbell, KY 42223 | 2016-05-10 |
| 1649644154 | Nathan Silvey | Physician Assistant | Building 4179, Fort Campbell, KY 42223 | 2015-11-20 |
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1275948564 | Rodney C Merkley | Psychologist | Building 3929, Ft. Capmbell, KY 42223 | 2014-06-25 |
| 1124438726 | Michael Bell | Social Worker | Blanchfield Army Community Hospital Attn: Credentials, 650 Joel Drive, Fort Campbell, KY 42223 | 2014-05-05 |
| Find all providers in zip 42223 | ||||
| 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 |
|---|---|---|---|---|
| 1396145306 | Blanchfield Army Community Hospital | Clinic/Center | Bldg 2403, Air Assault St and Indiana Ave, Fort Campbell, KY 42223 | 2014-08-27 |
| 1336575497 | Blanchfield Army Community Hospital | Clinic/Center | Toccoa Road Bldg 70344, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1518393677 | Blanchfield Army Community Hospital | Clinic/Center | 53rd Street and Indiana Ave, Bldg 3929, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1427484583 | Blanchfield Army Community Hospital | Clinic/Center | 55th Street and Indiana Avenue, Bldg 3960, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1154757219 | Blanchfield Army Community Hospital | Clinic/Center | 30th Street and Desert Storm Avenue, Bldg 6988, Fort Campbell, KY 42223-5318 | 2013-09-20 |
| 1306094909 | Blanchfield Army Community Hospital | Clinic/Center | 35th & Desert Storm, Bldg 5980, Fort Campbell, KY 42223 | 2008-09-08 |
| 1457556912 | Blanchfield Army Community Hospital | Clinic/Center | Indiana & 49th Street, Building 3603, Fort Campbell, KY 42223 | 2007-06-15 |
| 1215131933 | Blanchfield Army Community Hospital | Clinic/Center | 5580 Desert Storm Ave, Fort Campbell, KY 42223-5586 | 2007-06-14 |
| 1649665852 | Blanchfield Army Community Hospital | Clinic/Center | 6102 Tennessee Ave, Fort Campbell, KY 42223-5940 | 2015-04-03 |
| 1730493008 | Blanchfield Army Community Hospital | Clinic/Center | 650 Joel Dr, Cbpcc 2-ft. Campbell-hopkinsville Location, Fort Campbell, KY 42223-5318 | 2010-07-29 |
| Find all providers in FORT CAMPBELL | ||||
| City | FORT CAMPBELL |
| Zip Code | 42223 |
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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.