NPIMap

Organization Active NPI

United States Air Force

  • Clinic/Center
  • Charleston AFB, SC
National Provider Identifier
1023246659
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
UNITED STATES AIR FORCE
Practice address
204 W Hill Blvd
Charleston AFB, SC 29404-4704
Phone
(843) 963-6936
Fax
(843) 963-6903
NPI assigned
Jun 22, 2009
Last updated
Jun 22, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Ronnie Lee GodboltNPI 1104054659
Title
Independent Duty Medical Technician
Phone
(843) 963-6936

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

204 W Hill Blvd
Charleston AFB, SC 29404-4704

Mailing address

204 W Hill Blvd
Charleston AFB, SC 29404-4704
Phone (843) 963-6936

Other names 1

  • 437 Medical Group / CAFB Other name

National Provider Directory

National Provider Directory

Locations

204 W Hill Blvd
North Charleston, SC 29404
Phone (843) 963-6852

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245628800000",
    "number": "1023246659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "CHARLESTON AFB",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "843-963-6936",
            "fax_number": "843-963-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W HILL BLVD",
            "city": "CHARLESTON AFB",
            "state": "SC",
            "postal_code": "294044704",
            "telephone_number": "843-963-6936",
            "fax_number": "843-963-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED STATES AIR FORCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-22",
        "last_updated": "2009-06-22",
        "status": "A",
        "authorized_official_last_name": "GODBOLT",
        "authorized_official_first_name": "RONNIE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "INDEPENDENT DUTY MEDICAL TECHNICIAN",
        "authorized_official_telephone_number": "843-963-6936",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "437 Medical Group / CAFB",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Charleston AFB, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.