SCOTT AFB HOSPITAL (NPI# 1861478448) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861478448 |
| Entity Type | Organization |
| Organization Name | SCOTT AFB HOSPITAL |
| Practice Address |
310 W Losey St Scott Afb IL 62225-5250 |
| Practice Telephone | 6182566267 |
| Practice Fax Number | 6182567931 |
| Mailing Telephone | 6182566267 |
| Mailing Fax Number | 6182567931 |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. BRUCE JAY GARDNER II (RESIDENT PHYSICIAN) |
| Authorized Official Telephone | 6182566267 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 286500000X | Military Hospital | Hospitals |
| Street Address |
310 W LOSEY ST |
| City | SCOTT AFB |
| State | IL |
| Zip Code | 62225-5250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205839727 | Toney L Banks | Nurse Anesthetist, Certified Registered | 310 W Losey St, Scott Afb, IL 62225-5250 | 2005-05-30 |
| 1841814852 | Hilary Elizabeth Parsons | Student in an Organized Health Care Education/Training Program | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-06-04 |
| 1447874722 | Mauranda Nikki Bembry | Social Worker | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-06-03 |
| 1437778016 | Mark Alan Underhill | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-04-13 |
| 1194353276 | Kolin Daniel Cookson | Student in an Organized Health Care Education/Training Program | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-04-01 |
| 1831723592 | Linh Thuy Truong | Dentist | 310 W Losey St, Scott Afb, IL 62225-5250 | 2020-03-02 |
| 1346890894 | Crystal June Garcia | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-09-17 |
| 1740835602 | Andres Alejandro Paredes | Physician Assistant | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-08-07 |
| 1215580386 | Ryan Taylor Blalock | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-07-18 |
| 1063975001 | Collin Schroeder | Military Health Care Provider | 310 W Losey St, Scott Afb, IL 62225-5250 | 2019-04-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011645 | Cheryl D Jones | Registered Nurse | 375th Mdg, 310 W. Losey Street, Scott Afb, IL 62225 | 2020-04-13 |
| 1649836123 | Benjamin Truong | Student in an Organized Health Care Education/Training Program | Scott Air Force Base, 307 West Losey Street Building #1535, Apo, AA 62225 | 2019-05-10 |
| 1558925669 | Brian Ng | Student in an Organized Health Care Education/Training Program | South Drive, Scott Afb, Illinois, Apo, AA 62225 | 2019-04-24 |
| 1841853710 | Lance Scott Mcgavin | Student in an Organized Health Care Education/Training Program | 307 West Losey Street., Building #1535, Scott Afb, IL 62225 | 2019-04-17 |
| 1629503180 | Joshua Bryce Kessack | General Practice | 375 Amds, 310 Losey St, Scott Afb, IL 62225 | 2017-04-21 |
| 1265988059 | Jennifer Nicole Laurence | Dentist | 703 Seibert Rd Ste 5, Scott Afb, IL 62225 | 2016-08-31 |
| 1578940755 | Usv Optical Inc | Eyewear Supplier (Equipment, not the service) | 207 W. Winters St., Bldg 1981, Scott Afb, IL 62225 | 2015-04-27 |
| 1891193652 | Diana Meyer | Social Worker | Scott Afb, Apo, AA 62225 | 2014-12-10 |
| 1801210273 | Robie Victoria Hughes | Registered Nurse | 310 W Losey Street, Scott Air Force Base, IL 62225 | 2014-02-06 |
| 1487998746 | Melissa Dawn Goff | Military Health Care Provider | 310 West. Losey Street, Scott Afb, IL 62225 | 2012-11-26 |
| Find all providers in zip 62225 | ||||
| Taxonomy Code | 286500000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| A health care facility operated by the Department of Defense. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114287059 | United States Air Force | Military Hospital | 310 W Losey St, Scott Afb, IL 62225-5250 | 2012-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013212356 | Edward Hines Jr. Va Hospital | Military Hospital | 5800 W 105th St, Unit 2a, Oak Lawn, IL 60453-4385 | 2011-01-18 |
| 1114238649 | Edward Hines Jr Va | Military Hospital | 1110 W Wood Ave, Addison, IL 60101-5720 | 2010-06-30 |
| 1770819211 | Edward Hines Veteran's Hospital | Military Hospital | 5344 Carpenter St, Downers Grove, IL 60515-4807 | 2009-10-18 |
| 1316181183 | Resurrection Westlake Hospital | Military Hospital | 7311 W Montrose Ave, Norridge, IL 60706-1157 | 2009-04-23 |
| 1659401909 | Hines Va Hospital | Military Hospital | 5923 Ridge Ave, Berkeley, IL 60163-1545 | 2007-03-06 |
| 1679618482 | Hines Va Hospital | Military Hospital | 13037 S Houston Ave, Chicago, IL 60633-1704 | 2007-02-20 |
| 1366584815 | Hines Va Hospital | Military Hospital | 823 S Cuyler Ave, Oak Park, IL 60304-1507 | 2007-02-13 |
| 1891836037 | Hines Va | Military Hospital | 115 Fleetwood Dr, Glendale Heights, IL 60139-1931 | 2007-02-09 |
| 1245370907 | Edward Hines Va Hospital | Military Hospital | 1417 Carol St, Park Ridge, IL 60068-1205 | 2007-02-08 |
| 1285017848 | Federal Health Care Center | Military Hospital | 3001 Green Bay Rd, North Chicago, IL 60064 | 2015-07-01 |
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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.