36 MEDICAL GROUP (NPI# 1679540900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679540900 |
| Entity Type | Organization |
| Organization Name | 36 MEDICAL GROUP |
| Practice Address |
Unit 14010 Apo AP 96543 4010 UM |
| Practice Telephone | 6713666315 |
| Mailing Telephone | 6713666315 |
| Enumeration Date | 2006-03-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | CHRISTOPHER DOUGLAS EATON (AIR FORCE UNIFORM BUSINESS OFFICE P) |
| Authorized Official Telephone | 7036816303 |
| Is Organization Subpart | N |
| 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 |
| Street Address |
UNIT 14010 |
| City | APO |
| State | AP |
| Zip Code | 96543 4010 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417484858 | Ciera Domonique Paige Williams | Pharmacist | Unit 14010, Apo, AP 96543-4010 | 2017-05-16 |
| 1760890990 | Melan Davenport | Military Health Care Provider | Unit 14010, Apo, AP 96543-4010 | 2014-07-31 |
| 1255594107 | Cynthia Lynn-swearengin Pouncey | Dietitian, Registered | Unit 14010, Andersen Health and Wellness C, Apo, AP 96543-4010 | 2008-07-09 |
| 1558423863 | Shawn Wilson | Social Worker | Unit 14010, Apo, AP 96543-4010 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730591272 | Andrew Haynes | Student in an Organized Health Care Education/Training Program | 36 Mdg/sgsl, Unit 14010 Bldg 26001, Apo, AP 96543 | 2014-06-02 |
| 1831449537 | Amber R Schumacher | Military Health Care Provider | 36th Medical Group/sgoaf, Unit 14010 Bldg 26001, Apo, AP 96543 | 2012-09-11 |
| 1457636045 | Rebecca Joyce Scott | Pharmacist | 36th Medical Group, Unit 14010 Bldg 26001, Apo, AP 96543 | 2011-10-15 |
| 1588763536 | Andersen Phcy | Military/U.S. Coast Guard Pharmacy | Bldg 26000 Santa Rosa, Andersen Afb, GU 96543 | 2006-09-22 |
| 1285907139 | Nicholas Jon Hardgrave | Optometrist | 36th Medical Group-andersen Afb Clinic/optometry, Unit 14010, Apo, AP 96543-4003 | 2012-02-22 |
| 1942552930 | David Abraham Shwalb | Student in an Organized Health Care Education/Training Program | 36mdos/sgow (mental Health Services), Andersen Afb, Guam Unit 14010, Apo, AP 96543-4010 | 2012-10-15 |
| 1306071345 | Beth Marie Sherman | Military Health Care Provider | 36 Mdos/sgoaf, Unit 14010, Apo, AP 96543-4010 | 2009-05-20 |
| 1336257823 | Esther V. Rollen | Social Worker | 36mdos/sgoh, Unit 26012, Apo, AP 96543-4010 | 2006-08-26 |
| 1356378178 | James Matthew Kutner | Dentist | 36 Mdos/work Station, Unit 14010, Anderse Air Force Base Guam, Apo, AP 96543-4010 | 2006-06-27 |
| 1568576585 | Phillip Adriano | Military Health Care Provider | Hsc-25 Medical, Unit 14052 Box 51, Apo, AP 96543-4052 | 2006-08-18 |
| Find all providers in zip 96543 | ||||
| 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 |
|---|---|---|---|---|
| 1891982518 | Jtf-b Med El-honduras | Clinic/Center | Unit 5700, Apo, AA 34042 | 2007-09-26 |
| 1568660348 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 1665, Apo, AP 96205 | 2007-07-03 |
| 1811195696 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 3576, Apo, AP 96205 | 2007-07-03 |
| 1457559239 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 7005, Apo, AP 96205 | 2007-07-03 |
| 1730387515 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg S4034, Apo, AP 96205 | 2007-07-03 |
| 1306042494 | 121st Csh/baach | Clinic/Center | Unit 15658, Bldg 808, Apo, AP 96224 | 2007-06-25 |
| 1730385824 | 121st Csh/baach | Clinic/Center | Unit 15659, Bldg 220, Apo, AP 96218 | 2007-06-25 |
| 1215133301 | 121st Csh/baach | Clinic/Center | Unit 15660, Bldg 555, Apo, AP 96271 | 2007-06-25 |
| 1053517144 | 121st Csh/baach | Clinic/Center | Unit 15663, Bldg 600, Apo, AP 96297 | 2007-06-25 |
| 1700082880 | 121st Csh/baach | Clinic/Center | Unit 15652, Bldg 5107, Apo, AP 96205 | 2007-06-25 |
| Find all providers in APO | ||||
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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.