NPIMap

Organization Active NPI

Martin Army Community Hospital

Doing business as CTMC 2-Harmony Church

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fort Benning, GA
National Provider Identifier
1053624130
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
MARTIN ARMY COMMUNITY HOSPITAL
Doing business as
CTMC 2-Harmony Church
Practice address
6976 Old Cusseta Rd
Harmony Church
Fort Benning, GA 31905-5431
Phone
(706) 544-3278
NPI assigned
Jul 19, 2010
Last updated
Jan 20, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
MARTIN ARMY COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Authorized official

Name
Kertredia Davis, CCA, CPAR, CRCR
Title
Ubo Manager
Phone
(762) 408-0007

Specialties & licenses 1

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

Addresses

Primary practice location

6976 Old Cusseta Rd
Harmony Church
Fort Benning, GA 31905-5431

Mailing address

6600 Van Aalst Blvd BLDG 9250
Attn Treasury Office MCXB-PP
Fort Benning, GA 31905-2102
Phone (706) 544-5724

Other identifiers 1

IdentifierTypeStateIssuer
1194730846OtherPARENT BILLING NPI

Other names 1

  • CTMC 2-HARMONY CHURCH Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ach Martin-Benning28 organizations share this tax ID, including this one
Part of
Ach Martin-Benning

Other organizations with this tax ID 27

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

View all 27

Locations

7950 Martin Loop
Ofc
Fort Benning, GA 31905

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611100800000",
    "number": "1053624130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 VAN AALST BLVD BLDG 9250",
            "address_2": "ATTN TREASURY OFFICE MCXB-PP",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319052102",
            "telephone_number": "706-544-5724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6976 OLD CUSSETA RD",
            "address_2": "HARMONY CHURCH",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "319055431",
            "telephone_number": "706-544-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN ARMY COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARTIN ARMY COMMUNITY HOSPITAL",
        "enumeration_date": "2010-07-19",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "KERTREDIA",
        "authorized_official_title_or_position": "UBO MANAGER",
        "authorized_official_telephone_number": "762-408-0007",
        "authorized_official_credential": "CCA, CPAR, CRCR"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARENT BILLING NPI",
            "identifier": "1194730846",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CTMC 2-HARMONY CHURCH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CTMC 2-HARMONY CHURCH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Benning, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2021; 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.