62 MEDICAL GROUP (NPI# 1801837398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801837398 |
| Entity Type | Organization |
| Organization Name | 62 MEDICAL GROUP |
| Practice Address |
690 Barnes Blvd Attn: Sghc Mcchord Afb WA 98438 |
| Practice Telephone | 2539829918 |
| Practice Fax Number | 2539820283 |
| Mailing Telephone | 2539829918 |
| Mailing Fax Number | 2539820283 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2008-06-13 |
| Authorized Official Name | TESSIE M RIOS (CREDENTIALS MANAGER) |
| Authorized Official Telephone | 2539829918 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Street Address |
690 BARNES BLVD ATTN: SGHC |
| City | MCCHORD AFB |
| State | WA |
| Zip Code | 98438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891247706 | Air Force | Military Health Care Provider | 690 Barnes Blvd, Mcchord Afb, WA 98438-0000 | 2016-10-26 |
| 1164750998 | Jeanne Chavey Morrow | Social Worker | 690 Barnes Blvd, Mcchord Afb, WA 98438-1303 | 2009-12-07 |
| 1609023274 | Madigan Army Medical Ctr | Clinic/Center | 690 Barnes Blvd, Mcchord Afb, WA 98438-1303 | 2008-08-26 |
| 1366541401 | 62nd Med Grp | Military/U.S. Coast Guard Pharmacy | 690 Barnes Blvd, Mcchord Afb, WA 98438-1303 | 2006-09-22 |
| 1871602136 | Carolyn Kay Pittenger | Registered Nurse | 690 Barnes Blvd, 62nd Mdg, Mcchord Afb, WA 98438-1303 | 2006-08-30 |
| 1447288428 | Michael Daniel Jones | Psychologist | 690 Barnes Blvd, Mcchord Afb, WA 98438 | 2006-06-29 |
| 1952345696 | Jeff Brittain | Pharmacist | 690 Barnes Blvd, Mcchord Afb, WA 98438 | 2006-06-15 |
| 1811954811 | Vickie Knight | Registered Nurse | 690 Barnes Blvd, Mcchord Afb, WA 98438 | 2006-04-26 |
| 1992761290 | Sherri Ann Cote | Registered Nurse | 690 Barnes Blvd, Mcchord Afb, WA 98438 | 2006-04-25 |
| 1992761787 | Kathy Wainscott Berger | Registered Nurse | 690 Barnes Blvd, 62 Mdos/sgol, Mcchord Afb, WA 98374 | 2006-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457810483 | Roveds Kaarins | Nursing Care | Mcchord Air Force Base Clinic, 690 Barnes Blvd Jblm Lakewood Wa, Apo, AA 98438 | 2019-03-19 |
| 1326459843 | Dr Larsen Eye Care Inc | Optometrist | 504 A St Mcchord Main Exchange, Ft. Lewis Mcchord Afb, WA 98438 | 2014-05-19 |
| 1548580392 | Kevin Lok | Family Medicine | 600 Barnes Blvd., Mcchord Medical Clinic, Jblm, WA 98438 | 2010-06-03 |
| 1720205578 | Nathan Kane Fosmore | Registered Nurse | Us Dept of The Us Airforce, 690 Barnes Blvd, Mcchord Afb, WA 98438 | 2007-04-20 |
| 1225176951 | Ronald Richardson Morris | Family Medicine | 690 Barnes Road, Mcchord Medical Clinic Fam Med Clinic, Joint Base Lewis Mcchord, WA 98438 | 2007-02-02 |
| 1770527418 | National Vision, Inc. | Eyewear Supplier (Equipment, not the service) | A Street Bldg 504, Mcchord Afb, WA 98438 | 2006-06-15 |
| 1982660692 | Shanti Jones | Registered Nurse | 62nd Med Group, 690 Barnes Ave, Mcchord Afb, WA 98438 | 2006-04-21 |
| 1578547436 | Cynthia Lee Fry-spray | Physician Assistant | 691 Barnes Blvd, Mcchord Afb, WA 98438 | 2005-12-05 |
| 1366432171 | Robert Dean Rock | Dentist | 527 Barnes Blvd, Mcchord Air Forse Base Dental Clinic, Mcchord, WA 98438 | 2005-10-24 |
| 1457344913 | Norman Harris | Dentist | 62mdos/sgod 690 Barnes Blvd., Mcchord Afb, WA 98438 | 2005-08-30 |
| Find all providers in zip 98438 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992315808 | Vera Whole Health Wa, PC | Clinic/Center | 6700 Fort Dent Way Ste 100, Tukwila, WA 98188-2500 | 2020-08-05 |
| 1063037034 | Pioneer Family Medicine, Pllc | Clinic/Center | 20 E J St Ste 2b, Deer Park, WA 99006-8500 | 2020-06-15 |
| 1922622158 | Vera Whole Health Wa, PC | Clinic/Center | 16009 E Indiana Ave, Spokane Valley, WA 99216 | 2020-06-03 |
| 1578183729 | Family Care Network Pllc | Clinic/Center | 3548 Meridian St, Suite #101-b, Bellingham, WA 98225 | 2020-04-17 |
| 1548800451 | Vera Whole Health Wa PC | Clinic/Center | 1601 N Division St, Spokane, WA 99207-2427 | 2020-01-08 |
| 1821634312 | Columbia Basin Mobile Medicine LLC | Clinic/Center | 1357 Platinum Pl, West Richland, WA 99353-5108 | 2019-11-20 |
| 1063056497 | A Community Wellness Clinic LLC | Clinic/Center | 2405 E 17th Ave Ste 113, Spokane, WA 99223-5122 | 2019-10-29 |
| 1013550987 | Rejuventa Medical Corp. | Clinic/Center | 107 North Tower Ave Suite 17, Centralia, WA 98531-4253 | 2019-10-23 |
| 1023668407 | Vera Whole Health Wa, PC | Clinic/Center | 4933 Evergreen Way, Everett, WA 98203-2828 | 2019-09-17 |
| 1679042501 | Family and Wellness Medicine | Clinic/Center | 34004 16th Ave S Ste 100, Federal Way, WA 98003-8905 | 2018-11-20 |
| Find all providers with the same taxonomy | ||||
| City | MCCHORD AFB |
| Zip Code | 98438 |
Please comment or provide details below to improve the information on 62 MEDICAL GROUP.
| 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.