NPIMap

Organization Active NPI

Blanchfield Army Community Hospital

Doing business as Aviation Medicine Clin-Campbel

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fort Campbell, KY
National Provider Identifier
1073721734
Registry record updated Jan 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
BLANCHFIELD ARMY COMMUNITY HOSPITAL
Doing business as
Aviation Medicine Clin-Campbel
Practice address
7149 Blacksheep Run
Fort Campbell, KY 42223-5318
Phone
(270) 635-8849
NPI assigned
May 18, 2007
Last updated
Jan 5, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
BLANCHFIELD ARMY COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 5, 2015

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

Authorized official

Name
Liza J O'Neal
Title
C, Pad
Phone
(270) 798-8491

Specialties & licenses 1

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

Addresses

Primary practice location

7149 Blacksheep Run
Fort Campbell, KY 42223-5318

Mailing address

650 Joel Dr
Attn Ubo
Fort Campbell, KY 42223-5318
Phone (270) 798-8286

Other names 1

  • AVIATION MEDICINE CLIN-CAMPBEL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ach Blanchfield-Ft Campbell24 organizations share this tax ID, including this one
Part of
Ach Blanchfield-Ft Campbell

Other organizations with this tax ID 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420416000000",
    "number": "1073721734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "address_2": "ATTN UBO",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7149 BLACKSHEEP RUN",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-635-8849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
        "enumeration_date": "2007-05-18",
        "last_updated": "2015-01-05",
        "status": "A",
        "authorized_official_last_name": "O'NEAL",
        "authorized_official_first_name": "LIZA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "C, PAD",
        "authorized_official_telephone_number": "270-798-8491"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AVIATION MEDICINE CLIN-CAMPBEL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2015; 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.