82 MEDICAL GROUP


Address: 149 Hart St, Ste 1, Sheppard Afb, TX 76311-3478
Phone: 9406763388

82 MEDICAL GROUP (NPI# 1851376248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851376248
Entity Type Organization
Organization Name 82 MEDICAL GROUP
Practice Address 149 Hart St
Ste 1
Sheppard Afb
TX 76311-3478
Practice Telephone 9406763388
Enumeration Date 2005-12-08
Last Update Date 2010-11-19
Authorized Official Name SERENA LYNN HANSKEN (AIR FORCE UNIFORM BUSINESS OFFICE)
Authorized Official Telephone 7035886419
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QM1101X Clinic/Center
Specialization: Military and U.S. Coast Guard Ambulatory Procedure
Ambulatory Health Care Facilities
N 332000000X Military/U.S. Coast Guard Pharmacy Suppliers
Y 261QM1100X Clinic/Center
Specialization: Military/U.S. Coast Guard Outpatient
Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
TX NCPDP 4510699 01

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1073593570 82 Medical Group Clinic/Center 149 Hart St, Sheppard Afb, TX 76311-3477 2006-01-19

Office Location

Street Address 149 HART ST
STE 1
City SHEPPARD AFB
State TX
Zip Code 76311-3478

Providers in the same location

NPI Name Taxonomy Address Enumeration
1336133123 George Munkachy Psychologist 149 Hart St, 82nd Mdos/sgoh, Sheppard Afb, TX 76311-3477 2005-09-07
1861027476 Taylor J Morgan Pharmacist 149 Hart St, Sheppard Afb, TX 76311-3430 2020-03-04
1538721196 Jennifer Eileen Brown Nurse Practitioner 149 Hart St, Sheppard Afb, TX 76311-3430 2019-07-03
1174094551 Tiffany Machelle Esparza Social Worker 149 Hart St, Sheppard Afb, TX 76311-3430 2018-12-11
1235641713 Natalie Mounts Pharmacist 149 Hart St, Sheppard Afb, TX 76311-3430 2017-10-24
1730603978 Kelly Lynn Hall Physician Assistant 149 Hart St, 82nd Mdos/sgop Family Practice, Sheppard Afb, TX 76354 2017-07-31
1588199129 Julie Ojongofu Pharmacist 149 Hart St, 82 Mdg, Sheppard Afb, TX 76311-3430 2017-04-20
1437604469 Marland Fox Physician Assistant 149 Hart St, Bldg 1200, Sheppard Afb, TX 76311-3430 2016-08-19
1386019669 Matthew Robertson Physical Therapist 149 Hart St, Sheppard Afb, TX 76311-3430 2015-12-11
1265818512 Helena Guerra Nurse Practitioner 149 Hart St, Sheppard Afb, TX 76311-3430 2015-08-09
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1740792076 Hunter Tristan Justice Ferguson Military Health Care Provider 527 I Ave Unit 72, Sheppard Afb, TX 76311 2017-10-26
1588083356 Keenan David Atwood Emergency Medicine 145 Hart St, Aerospace Medicine Clinic, Sheppard Afb, TX 76311 2014-04-09
1649525338 Austin Douglas Solomons Social Worker 82 Medical Group, 149 Hart Street, Sheppard Afb, TX 76311 2012-07-18
1700162831 Kristina Marie Zuccarelli Student in an Organized Health Care Education/Training Program 132 Hart Street, Sheppard Afb, TX 76311 2011-11-03
1679859367 Brandon William Keyser Dentist 82 Dental Squadron/sgd, 149 Hart St Ste 4, Sheppard Afb, TX 76311 2011-10-26
1437456373 Jennifer Leigh Noblin Military Health Care Provider Sheppard Afb Mental Health Clinic, 149 Hart St. Bldg 1200, Wichita Falls, TX 76311 2011-02-11
1336450444 Allen Chan Dentist 82nd Medical Group (aetc) Pas: Sq0jfb5d, Sheppard Afb, Apo, AA 76311 2010-06-24
1003140344 Christopher Shawn Couch Military Health Care Provider 718 I Ave 82 Mss/dpf, Bldg 1900 Dept Xufb, Sheppard Afb, TX 76311 2009-09-18
1124255583 Danny Lee Dennis Jr. Military Health Care Provider 939 Missile Road Bld 1900, Wichita Falls, TX 76311 2009-06-12
1902008980 Jason West Cromar Military Hospital 149 G W Hart St., Bldg. 1200, 82 Mdg/sgp, Sheppard Afb, TX 76311 2007-06-01
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Taxonomy Information

Taxonomy Code 261QM1100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Military/U.S. Coast Guard Outpatient

Taxonomy Definition

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]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1326527177 William Beaumont Army Medical Center Clinic/Center 11291 Sgt E Churchill St, Fort Bliss, TX 79918-8001 2018-08-13
1124505359 Carl R Darnall Army Medical Center Clinic/Center 5200 Bunny Trail, Killeen, TX 76549 2018-07-20
1568948933 Carl R Darnall Army Medical Center Clinic/Center 415 31st and 761st Tank Battalion, Fort Hood, TX 76544 2018-07-18
1740766112 Carl R Darnall Army Medical Center Clinic/Center Bldg 2255 52nd and 761st Tank Battalion, Fort Hood, TX 76544 2018-07-18
1396119681 Brooke Army Medical Center Clinic/Center 2407 N New Braunfels, Bldg 147, Ft Sam Houston, TX 78234 2015-11-24
1932595204 Carl R Darnall Army Medical Center Clinic/Center 9410 19th St, Fort Hood, TX 76544 2015-04-13
1154717650 Carl R Darnall Army Medical Center Clinic/Center 31002 74th Street, Fort Hood, TX 76544 2015-04-10
1073909578 Carl R Darnall Army Medical Center Clinic/Center 37016 77th Street, Fort Hood, TX 76544 2015-04-10
1972999472 Carl R Darnall Army Medical Center Clinic/Center 24001 Battalion Ave, 58th and 62nd Streets, Fort Hood, TX 76544 2015-04-10
1619365285 Brooke Army Medical Center Clinic/Center 10010 Rogers Run, Suite 100, San Antonio, TX 78251-4403 2015-01-05
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Competitor

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City SHEPPARD AFB
Zip Code 76311

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Dataset Information

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.

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