LYSTER ARMY HEALTH CLINIC (NPI# 1821410242) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821410242 |
| Entity Type | Organization |
| Organization Name | LYSTER ARMY HEALTH CLINIC |
| Practice Address |
Lyster Army Health Clinic Building 301 Andrews Avenue Fort Rucker AL 36362-5333 |
| Mailing Address |
Building 301 Andrews Avenue Lyster Army Health Clinic Fort Rucker AL 36362-5333 |
| Practice Telephone | 3342557636 |
| Practice Fax Number | 3342557368 |
| Mailing Telephone | 3342557636 |
| Mailing Fax Number | 3342557368 |
| Enumeration Date | 2014-01-21 |
| Last Update Date | 2014-01-21 |
| Authorized Official Name | AMANDA LEE GONZALEZ (NREMT) |
| Authorized Official Telephone | 3342557636 |
| 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 |
E2089197 | TX | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174774863 | Lyster Army Health Clinic | Military Hospital | 301dustoff Ave, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2008-10-01 |
| 1447407218 | Lyster Army Health Clinic | Military Hospital | Building 301, Andrews Ave, Lyster Army Health Clinic, Fpo, AE 36362-5333 | 2008-08-25 |
| 1093978454 | Lyster Army Health Clinic | Military Hospital | Buliding 301 Andrews Ave, Lyster Army Health Clinic, Fpo, AA 36362-5333 | 2008-07-07 |
| 1366610115 | Lyster Army Health Clinic | Clinic/Center | Dept of Primary Care&community Med, Fort Rucker, AL 36362 | 2008-02-14 |
| 1366610123 | Lyster Army Health Clinic | Clinic/Center | Lyster Army Health Clinic Bldg. 301, Ft. Rucker, AL 36362 | 2008-02-14 |
| 1255519740 | Lyster Army Health Clinic | Clinic/Center | Andrews Ave, Building 301, Ft Rucker, AL 36362 | 2008-02-06 |
| 1033532486 | Lyster Army Health Clinic | Clinic/Center | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2014-01-21 |
| 1093029027 | Lyster Army Health Clinic | Clinic/Center | Lyster Army Health Clinic, Bldg 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2010-08-02 |
| 1568612497 | Lyster Army Health Clinic | Military Hospital | Bldg 301, Andrews Ave, Lyster Army Health Clinic, Fpo, AE 36362-5333 | 2008-09-29 |
| 1316197452 | Lyster Army Health Clinic | Military Hospital | Andrews Ave, Bldg 301, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2008-09-25 |
| Street Address |
LYSTER ARMY HEALTH CLINIC BUILDING 301 ANDREWS AVENUE |
| City | FORT RUCKER |
| State | AL |
| Zip Code | 36362-5333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912964115 | Wendy Ruth Campbell | Nurse Practitioner | Lyster Army Health Clinic, 301 Andrews Avenue, Fort Rucker, AL 36362 | 2006-05-01 |
| 1598311409 | Catherine Rebecca Baden | Technician | Lyster Army Health Clinic, Bldg 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-08-15 |
| 1447802392 | Ginger Lynn Tanner | Registered Nurse | Lyster Army Health Clinic, Building 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-07-11 |
| 1659923506 | Joni E Prugh | Physical Therapy Assistant | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-07-11 |
| 1063074805 | Crystal Harris | Emergency Medical Technician, Basic | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-07-02 |
| 1871158444 | Dorma Sanders | Registered Nurse | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-05-08 |
| 1942769047 | Emily Sue Canlas | Registered Nurse | Lyster Army Health Clinic, Bldg. 301 Andrews Ave., Fort Rucker, AL 36362-5333 | 2019-03-18 |
| 1366900821 | Michael Joseph Brown | Emergency Medical Technician, Basic | Lyster Army Health Clinic, Building 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-03-04 |
| 1861956823 | Katherine Lambeth | Technician/Technologist | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-01-24 |
| 1376014480 | Patrick Gabriel Lawson | Emergency Medical Technician, Paramedic | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2018-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
| 1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
| 1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
| 1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
| 1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
| 1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
| 1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
| Find all providers in zip 36362 | ||||
| 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 |
|---|---|---|---|---|
| 1144423617 | United States Army Aeromedical Center | Clinic/Center | 4405 Innkeeper Street, Fort Rucker, AL 36362 | 2007-06-11 |
| 1932122314 | United States Army Aeromedical Center | Clinic/Center | 301 Andrews Rd, Fort Rucker, AL 36362 | 2006-07-25 |
| 1033532486 | Lyster Army Health Clinic | Clinic/Center | 301 Andrews Avenue, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2014-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396738944 | Maxwell Afb Ambulatory Health Care Center | Clinic/Center | 300 S. Twining Street, Bldg 760, Family Practice - Yellow Team, Maxwell Afb, AL 36112 | 2005-08-30 |
| 1033541156 | Us Coast Guard | Clinic/Center | 8501 Tanner Williams Rd, Mobile, AL 36608-8322 | 2013-07-31 |
| 1760673784 | U. S. Coast Guard Aviation Training Center Mobile | Clinic/Center | 8501 Tanner Williams Rd, Mobile, AL 36608-8322 | 2007-08-05 |
| 1871796334 | Fox Army Health Center | Clinic/Center | 4100 Goss Rd Sw, Usadc-1, Huntsville, AL 35809-0001 | 2007-06-11 |
| 1790889053 | Centeral Alabama Veterans Health Care System | Clinic/Center | 215 Perry Hill Rd, Montgomery, AL 36109-3725 | 2006-09-08 |
| City | FORT RUCKER |
| Zip Code | 36362 |
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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.