Wright Patterson Medical Center

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

086051 Issued in OH

Legal business name

WRIGHT PATTERSON MEDICAL CENTER

Practice address

4881 Sugar Maple Dr
Wright Patterson AFB, OH 45433-5546

Phone

(937) 257-9454

NPI assigned

Oct 31, 2005

Reactivated

Apr 19, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Douglas Eaton

Title

Air Force Uniform Business Office

Phone

(703) 681-6303

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1124019047. Details of each certification follow.

• CCN 36042F Hospital · Active · Name & address match · Details

Hospital certification: CCN 36042F

Legal name

AIRFORCE MEDICAL CTR WRIGHT-PATTERSON

Certification status

Active

Provider type (POS)

Hospital

Participating since

Jan 18, 2002

Last certification

Jan 18, 2002

Beds

135

Facility address

4881 Sugar Maple Drive
Wright Patterson AFB, OH 45433

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• 88TH Medgrp-Wright-Patterson

  • Psychiatric Hospital Unit
  • Wpafb, OH
  • NPI 1124206594
  NPPES parent name

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124019047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6604 KELTON PL",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454247116",
            "telephone_number": "937-236-1138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4881 SUGAR MAPLE DR",
            "city": "WRIGHT PATTERSON AFB",
            "state": "OH",
            "postal_code": "454335546",
            "telephone_number": "937-257-9454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WRIGHT PATTERSON MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-08-22",
        "deactivation_date": "2006-05-25",
        "reactivation_date": "2007-04-19",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "AIR FORCE UNIFORM BUSINESS OFFICE",
        "authorized_official_telephone_number": "703-681-6303"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OH",
            "license": "086051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Halei K Wong, M.D.
• Charles Paige Wood, M.D.
• Joe Dunham Wood III, PSYD
• Richard Wood, D.O.
• Robert A Wootton, PHARMD
• Steve Thomas Wright, OD, MS
• Michael Stephan Xydakis, MD, MSC
• Adam N Young, DO
• Ilene Young
• Jaaron Alexander Zentz

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.