NPIMap

Organization Active NPI

Branch Medical Clinic Bancroft Hall

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Annapolis, MD
National Provider Identifier
1033315080
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
BRANCH MEDICAL CLINIC BANCROFT HALL
Practice address
121 Blake Rd
Annapolis, MD 21402-1300
Phone
(410) 293-1771
NPI assigned
Jun 26, 2007
Last updated
Dec 19, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
NAVAL HEALTH CLINIC ANNAPOLISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Authorized official

Name
Mr. William Michael Condon
Title
Navy Medicine Ubo Program Manager
Phone
(240) 401-3643

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X Primary

Addresses

Primary practice location

121 Blake Rd
Annapolis, MD 21402-1300

Mailing address

8901 Wisconsin Ave
PSC Box 509 Code 6300
Bethesda, MD 20889-0001
Phone (301) 295-4934

National Provider Directory

National Provider Directory
Tax ID family
Branch Medical Clinic Lakehurst9 organizations share this tax ID, including this one
Part of
Branch Medical Clinic Lakehurst

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

121 Blake Rd
Naval Academy, MD 21402
Phone (410) 293-1771

NPI Registry JSON

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

{
    "created_epoch": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1033315080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8901 WISCONSIN AVE",
            "address_2": "PSC BOX 509 CODE 6300",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "301-295-4934",
            "fax_number": "301-295-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 BLAKE RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214021300",
            "telephone_number": "410-293-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC BANCROFT HALL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HEALTH CLINIC ANNAPOLIS",
        "enumeration_date": "2007-06-26",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "NAVY MEDICINE UBO PROGRAM MANAGER",
        "authorized_official_telephone_number": "240-401-3643",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.