NPIMap

Organization Active NPI

United States Navy

Doing business as Navy Medicine Support Command

  • Military Ambulatory Procedure Visits Operational (Transportable) Clinic/Center
  • Jacksonville, FL
National Provider Identifier
1043632771
Registry record updated Feb 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Ambulatory Procedure Visits Operational (Transportable) Clinic/CenterTaxonomy code 261QM1103X
Legal business name
UNITED STATES NAVY
Doing business as
Navy Medicine Support Command
Practice address
2005 Knight Lane BLDG H
Navy Medicine Support Command Attn: Medical Staff SVCS
Jacksonville, FL 32212-0140
Phone
(760) 725-3213
NPI assigned
Jan 15, 2014
Last updated
Feb 20, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2014

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

Authorized official

Name
Mr. Derek Edward Weiss, MPAS
Title
PA
Phone
(760) 725-3213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Ambulatory Procedure Visits Operational (Transportable) Clinic/Center 261QM1103X Primary

Addresses

Primary practice location

2005 Knight Lane BLDG H
Navy Medicine Support Command Attn: Medical Staff SVCS
Jacksonville, FL 32212-0140

Mailing address

2005 Knight Lane BLDG H
Navy Medicine Support Command Attn: Medical Staff SVCS
Jacksonville, FL 32212-0140
Phone (760) 725-3213

Other names 1

  • Navy Medicine Support Command Doing business as

National Provider Directory

National Provider Directory
Tax ID family
John Keeling63 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1043632771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2005 KNIGHT LANE BLDG H",
            "address_2": "NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322120140",
            "telephone_number": "760-725-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2005 KNIGHT LANE BLDG H",
            "address_2": "NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322120140",
            "telephone_number": "760-725-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED STATES NAVY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "DEREK",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PA",
        "authorized_official_telephone_number": "760-725-3213",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPAS"
    },
    "taxonomies": [
        {
            "code": "261QM1103X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military Ambulatory Procedure Visits Operational (Transportable)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Navy Medicine Support Command",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.