BRANCH MEDICAL CLINIC BANGOR (NPI# 1932302262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932302262 |
| Entity Type | Organization |
| Organization Name | BRANCH MEDICAL CLINIC BANGOR |
| Practice Address |
2050 Barb St Silverdale WA 98315 |
| Mailing Address |
1 Boone Rd Code 08razd Bremerton WA 98312-1894 |
| Practice Telephone | 3603154391 |
| Practice Fax Number | 3603964247 |
| Mailing Telephone | 3604754160 |
| Mailing Fax Number | 3604754676 |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2018-05-25 |
| Authorized Official Name | WILLIAM M CONDON (BUMED UBO) |
| Authorized Official Telephone | 2404013643 |
| Is Organization Subpart | Y |
| Parent Organization Name | NAVAL HOSPITAL BREMERTON |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1100X |
Clinic/Center Specialization: Military/U.S. Coast Guard Outpatient |
Ambulatory Health Care Facilities |
| Street Address |
2050 BARB ST |
| City | SILVERDALE |
| State | WA |
| Zip Code | 98315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013987122 | Frederick Gilbert Young | Dentist | 2050 Barb St, Suite B, Silverdale, WA 98315-2050 | 2006-01-23 |
| 1306482211 | Skylar Jo Snowden | Dentist | 2050 Barb St, Silverdale, WA 98315-2050 | 2019-11-26 |
| 1952963365 | Lance Richard Harris | Dentist | 2050 Barb St, Silverdale, WA 98315-2050 | 2019-07-05 |
| 1437672466 | Tracy Rowley | Dental Hygienist | 2050 Barb St, Silverdale, WA 98315-2050 | 2017-07-21 |
| 1134583636 | Collin Barker | Dentist | 2050 Barb St, Silverdale, WA 98315-2050 | 2016-04-11 |
| 1851772891 | Robert Blackmon | Military Health Care Provider | 2050 Barb St, Silverdale, WA 98315 | 2015-06-16 |
| 1427398296 | Rudy F Schmiedecke | Military Health Care Provider | 2050 Barb St, Silverdale, WA 98315-2050 | 2013-02-15 |
| 1992093538 | Daniel Bradley | Family Medicine | 2050 Barb St, Silverdale, WA 98315-2050 | 2011-07-18 |
| 1447584545 | Michael Anthony Smith | Dentist | 2050 Barb St, Suite #b, Silverdale, WA 98315-2098 | 2009-09-23 |
| 1912196221 | Randall Evan Moss | Physician Assistant | 2050 Barb St, Silverdale, WA 98315 | 2007-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700044500 | Tina Louise Toles | Military Health Care Provider | Marine Corps Security Forces Battalion, Fpo, AP 98315 | 2008-05-28 |
| 1235340738 | Edward Cliff Littler | Military Health Care Provider | Uss Henry M Jackson (ssbn 730)(blue), Fpo Ap, Bangor, WA 98315 | 2007-05-25 |
| 1871705673 | Christopher Lee Drennon | Military Health Care Provider | Mcsfco Bangor, Silverdlae, WA 98315 | 2007-05-04 |
| 1043317803 | Naval Hospital Bremerton | Military/U.S. Coast Guard Pharmacy | 2050 Barb St Ste A, Silverdale, WA 98315 | 2006-09-20 |
| 1538191283 | Matthew H Mcclernan | Military Health Care Provider | Uss Kentucky Ssbn 737 Gold, 2100 Thresher Ave, Silverdale, WA 98315 | 2006-07-06 |
| 1962723668 | Christopher Deon Davis | Military Health Care Provider | 2100 Thresher Ave, Uss Henry M Jackson Ssbn 730(g), Silverdale, WA 98315 | 2010-06-16 |
| 1366773038 | Mario M Faria | Military Health Care Provider | 2100 Thresher Ave, Uss Pennsylvania Ssbn 735, Silverdale, WA 98315 | 2010-01-20 |
| 1386689560 | Richard E Bolton | Military Health Care Provider | 2100 Thresher Ave, Uss Nevada, Silverdale, WA 98315 | 2006-06-19 |
| 1003442310 | Gary Whittaker | Marriage & Family Therapist | 1099 Tautog Circle, Silverdale, WA 98315-1012 | 2020-03-18 |
| 1609976406 | Robert Bruce Ludy | Personal Emergency Response Attendant | 2000 Thresher Ave, Silverdale, WA 98315-2004 | 2006-09-22 |
| Find all providers in zip 98315 | ||||
| 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 |
|---|---|---|---|---|
| 1770975583 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3749, Tacoma, WA 98431-0001 | 2015-03-03 |
| 1376974303 | Madigan Army Medical Ctr | Clinic/Center | 3 Rd Division Dr Bldg R3150, Tacoma, WA 98431-0001 | 2013-12-02 |
| 1588094213 | Madigan Army Medical Ctr | Clinic/Center | C St Bldg R1880, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1043640774 | Madigan Army Medical Ctr | Clinic/Center | Railroad Ave Bldg R3742, Tacoma, WA 98431-0001 | 2013-11-15 |
| 1750719761 | Madigan Army Medical Ctr | Clinic/Center | 5 Th St Bldg 9025, Tacoma, WA 98431-0001 | 2013-10-30 |
| 1801152723 | Madigan Army Medical Ctr | Clinic/Center | 13815 8th St, Joint Base Lewis Mcchord, WA 98431-0001 | 2012-04-04 |
| 1851605356 | Madigan Army Medical Ctr | Clinic/Center | 15600 Meridan Ave, Sunrise Village Center, East Puyallup, WA 98374 | 2010-07-27 |
| 1881907822 | Madigan Army Medical Ctr | Clinic/Center | 3415 Pacific Ave Se, Suite D1, Olympia, WA 98501-2173 | 2010-07-20 |
| 1497952667 | Madigan Army Medical Ctr | Clinic/Center | Building R3125, Bennett Avenue, Fort Lewis, WA 98433 | 2007-06-29 |
| 1992902571 | Madigan Army Medical Ctr | Clinic/Center | Dc#2 Building 3740p, Fort Lewis, WA 98433 | 2007-06-28 |
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| City | SILVERDALE |
| Zip Code | 98315 |
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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.