United States Air Force

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

4301405356 Issued in MI

Legal business name

UNITED STATES AIR FORCE

Practice address

4881 Sugar Maple Dr
88 MDG/Mdos
Wright Patterson AFB, OH 45433-5546

Phone

(937) 257-4439

NPI assigned

Jan 12, 2006

Organization subpart

No

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

Authorized official

Name

Jackie Barbour

Title

Credentials

Phone

(937) 257-1942

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104805688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "address_2": "88 MDG/MDOS",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "address_2": "88 MDG/MDOS",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335546",
            "telephone_number": "937-257-4439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNITED STATES AIR FORCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARBOUR",
        "authorized_official_first_name": "JACKIE",
        "authorized_official_title_or_position": "CREDENTIALS",
        "authorized_official_telephone_number": "937-257-1942"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MI",
            "license": "4301405356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Torres-Reyes, M.D., M.P.H.
• Brandon M Tourtillott, PH.D. CCC-A
• Ryan Lee Traver, O.D.
• Christopher Makoto Tsueda, M.D.
• Anthony Paul Tvaryanas, M.D., P.H.D., M.P.H.
• United States Air Force
• Thaddaeus M Vaichus
• William Joseph Valko, M.D.
• Richard E Vanarsdel, O.D.
• Anna M Vance, CRNA

• General Acute Care Hospital in Wright Patterson AFB, OH
• Providers in Wright Patterson AFB, OH by specialty
• General Acute Care Hospital in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.