NPIMap

Organization Active NPI

Kimbrough Acc Military MTF

Doing business as Usadc Edgewood Arsenal

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Aberdeen Proving Ground, MD
National Provider Identifier
1093910374
Registry record updated Dec 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
KIMBROUGH ACC MILITARY MTF
Doing business as
Usadc Edgewood Arsenal
Practice address
4110 Austin Road
Aberdeen Proving Ground, MD 21010
Phone
(410) 278-1824
NPI assigned
Jun 18, 2007
Organization subpart
Yes
Parent organization
KIMBROUGH ACC MILITARY MTFAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2012

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

Authorized official

Name
Terri Kimbrow
Title
Ubo Manager
Phone
(301) 677-8512

Specialties & licenses 1

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

Addresses

Primary practice location

4110 Austin Road
Aberdeen Proving Ground, MD 21010

Mailing address

2480 Llewellyn Ave
CDR Usameddac MCXR-BD Ste 5800
Fort Meade, MD 20755-7081
Phone (301) 677-8253

Other names 1

  • USADC EDGEWOOD ARSENAL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ft Meade Meddac25 organizations share this tax ID, including this one
Part of
Ft Meade Meddac

Other organizations with this tax ID 24

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

View all 24

Locations

4110 Austin Rd
Gunpowder, MD 21010
Phone (410) 278-1824

NPI Registry JSON

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355788800000",
    "number": "1093910374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "address_2": "CDR USAMEDDAC MCXR-BD STE 5800",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 AUSTIN ROAD",
            "city": "ABERDEEN PROVING GROUND",
            "state": "MD",
            "postal_code": "21010",
            "telephone_number": "410-278-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBROUGH ACC MILITARY MTF",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIMBROUGH ACC MILITARY MTF",
        "enumeration_date": "2007-06-18",
        "last_updated": "2012-12-18",
        "status": "A",
        "authorized_official_last_name": "KIMBROW",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "UBO MANAGER",
        "authorized_official_telephone_number": "301-677-8512"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USADC EDGEWOOD ARSENAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aberdeen Proving Ground, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; 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.