NPIMap

Organization Active NPI

Kimbrough Acc Military MTF

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fort Meade, MD
National Provider Identifier
1124223797
Registry record updated Apr 1, 2015
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
Practice address
8472 Simmond St
Fort Meade, MD 20755-5700
Phone
(301) 677-8800
NPI assigned
Jun 15, 2007
Organization subpart
Yes
Parent organization
KIMBROUGH ACC MILITARY MTFAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

8472 Simmond St
Fort Meade, MD 20755-5700

Mailing address

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

Other names 1

  • USADC EPES-MEADE 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

8472 Simmond St
Fort Meade, MD 20755
Phone (301) 677-6078

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1124223797",
    "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": "8472 SIMMOND ST",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207555700",
            "telephone_number": "301-677-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBROUGH ACC MILITARY MTF",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIMBROUGH ACC MILITARY MTF",
        "enumeration_date": "2007-06-15",
        "last_updated": "2015-04-01",
        "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 EPES-MEADE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Meade, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.