UNITED STATES NAVY (NPI# 1730249079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730249079 |
| Entity Type | Organization |
| Organization Name | UNITED STATES NAVY |
| Practice Address |
704 Guenevere Dr Ballwin MO 63011-3525 |
| Practice Telephone | 6363862729 |
| Practice Fax Number | 6365278189 |
| Mailing Telephone | 6363862729 |
| Mailing Fax Number | 6365278189 |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. GARY GEORGE NITZ (NURSE ANESTHETIST) |
| Authorized Official Telephone | 3145189118 |
| Authorized Official Credential | CRNA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2865X1600X |
Military Hospital Specialization: Military General Acute Care Hospital. Operational (Transportable) |
064569 | MO | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568905511 | United States Navy | Military Health Care Provider | 1st Mardiv 7th Marine Reg, Navpers Office Bldg 1525, 29 Palms, CA 92278-8150 | 2016-11-23 |
| 1235508557 | United States Navy | Clinic/Center | Psc Box 20098, Hq and Service Co, 1st Bn, 6th Marine Regt, 2d Mardiv, Camp Lejeune, NC 28542-0098 | 2015-09-16 |
| 1588066294 | United States Navy | Military Health Care Provider | Unit 38445, Fpo, AP 96373-8445 | 2014-09-24 |
| 1649682154 | United States Navy | Military Hospital | Logistics Support Unit Onemedic, 2424 Redova Rd Bldg 156, San Diego, CA 92155-5401 | 2014-06-02 |
| 1679824585 | United States Navy | Military Hospital | Bldg 14137, Camp Pendleton, CA 92055-5697 | 2012-10-02 |
| 1295009728 | United States Navy | Military Health Care Provider | 667 Orangewood Dr, Virginia Beach, VA 23453-2124 | 2012-03-01 |
| 1427328319 | United States Navy | Military Hospital | 2005 Knight Ln., Bldg H Navy Medicine Support Command, Jacksonville, FL 32212-0140 | 2012-01-09 |
| 1285916072 | United States Navy | Military Health Care Provider | 318 S French Ct, Virginia Beach, VA 23454-4225 | 2011-09-16 |
| 1396047866 | United States Navy | Military Hospital | 5065 Sunburst St, Joshua Tree, CA 92252-1831 | 2010-12-03 |
| 1881909380 | United States Navy | Military Hospital | 01 Boone Rd, Bremerton, WA 98382 | 2010-08-10 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | UNITED STATES NAVY MEMORIAL FOUNDATION | 701 Pennsylvania Ave Nw Ste 123, Washington, DC 20004-2688 |
| Oklahoma Business Registrations | UNITED STATES NAVY MEMORIAL FOUNDATION | 701 Pennsylvania Ave Nw #123, Washington, DC 20004-2608 |
| Street Address |
704 GUENEVERE DR |
| City | BALLWIN |
| State | MO |
| Zip Code | 63011-3525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205309234 | Heather Renee Leone | Nurse Practitioner | 452 Sovereign Court Suite A, Ballwin, MO 63011 | 2019-01-02 |
| 1538635297 | Jennifer Lea Nicole O'donnell | Registered Nurse | 13861 Manchester Road, Town and Country, MO 63011 | 2018-10-22 |
| 1285127712 | Genevieve Friedmann | Social Worker | 301 Sovereign Ct Ste 103, Ballwin, MO 63011 | 2018-06-09 |
| 1881187391 | Andrew Cittadino Link | Dentist | 14335 Manchester Road, Ballwin, MO 63011 | 2018-06-08 |
| 1972041283 | Anavan LLC | Durable Medical Equipment & Medical Supplies | 14390 Manchester Rd, Saint Louis, MO 63011 | 2017-02-07 |
| 1780131300 | Autism and Behavioral Spectrum LLC | Day Training, Developmentally Disabled Services | 14733 Clayton Road, Chesterfield, MO 63011 | 2016-09-01 |
| 1265872964 | Eryn Nichole Miner | Behavioral Analyst | 15834 Clayton Road, Ellisville, MO 63011 | 2013-06-27 |
| 1194168765 | Donna Margaret Carrillo | Developmental Therapist | 15834 Clayton Rd., Ellisville, MO 63011 | 2013-04-12 |
| 1891047486 | Ashley Amanda Battaglia | Chiropractor | 15945 Clayton Rd Ste 230c, Ballwin, MO 63011 | 2012-10-08 |
| 1750658480 | Gary Frank Sobocinski | Pharmacist | 4033 Sovereign Court, Ballwin, MO 63011 | 2011-11-23 |
| Find all providers in zip 63011 | ||||
| Taxonomy Code | 2865X1600X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| Specialization | Military General Acute Care Hospital. Operational (Transportable) |
| A Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in "non-fixed" or deployed facilities. Entity is not Defense Health Program funded. Services are primarily intended for DoD active duty though some services may be furnished for non-DoD active duty. "Non-fixed" facilities are generally deployed DoD health care activities, not providing services on or in association with a DoD fort or base. "Non-fixed" facilities include hospital ships. |
| Notes: [1/1/2005: title modified, definition added] |
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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.