NPIMap

Organization Active NPI

Intrepid Spirit Center

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Camp Pendleton, CA
National Provider Identifier
1184187296
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
INTREPID SPIRIT CENTER
Practice address
200 Mercy Cir
Camp Pendleton, CA 92055
Phone
(619) 767-7000
NPI assigned
Apr 8, 2019
Last updated
Apr 8, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
NAVAL HOSPITAL CAMP PENDLETONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Authorized official

Name
William M Condon
Title
Ubo Manager
Phone
(240) 401-3643

Specialties & licenses 1

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

Addresses

Primary practice location

200 Mercy Cir
Camp Pendleton, CA 92055

Mailing address

200 Mercy Cir
Camp Pendleton, CA 92055

National Provider Directory

National Provider Directory
Tax ID family
Branch Dental Clinic San Onofre43 organizations share this tax ID, including this one
Part of
Branch Dental Clinic San Onofre

Other organizations with this tax ID 42

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

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554681600000",
    "number": "1184187296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MERCY CIR",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MERCY CIR",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "619-767-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTREPID SPIRIT CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HOSPITAL CAMP PENDLETON",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "UBO MANAGER",
        "authorized_official_telephone_number": "240-401-3643"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camp Pendleton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.