NPIMap

Organization Active NPI

US Army

  • Operational (Transportable) Military General Acute Care Hospital
  • Fort Campbell, KY
National Provider Identifier
1205145695
Registry record updated Oct 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Operational (Transportable) Military General Acute Care HospitalTaxonomy code 2865X1600X
Legal business name
US ARMY
Practice address
650 Joel Dr
C/O Don Black, Blue Clinic
Fort Campbell, KY 42223-5318
Phone
(270) 956-0178
NPI assigned
Oct 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2010

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

Authorized official

Name
Mr. Donald Black, MPA-C
Title
Ipap Phase 2 Director
Phone
(270) 956-0178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Operational (Transportable) Military General Acute Care Hospital 2865X1600X Primary

Addresses

Primary practice location

650 Joel Dr
C/O Don Black, Blue Clinic
Fort Campbell, KY 42223-5318

Mailing address

3110 Lylewood Rd
Woodlawn, TN 37191-8232
Phone (931) 542-6193

National Provider Directory

National Provider Directory
Tax ID family
US Army42 organizations share this tax ID, including this one

Other organizations with this tax ID 41

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

View all 41

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285891200000",
    "number": "1205145695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3110 LYLEWOOD RD",
            "city": "WOODLAWN",
            "state": "TN",
            "postal_code": "371918232",
            "telephone_number": "931-542-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "address_2": "C/O DON BLACK, BLUE CLINIC",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-956-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US ARMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-01",
        "last_updated": "2010-10-01",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "IPAP PHASE 2 DIRECTOR",
        "authorized_official_telephone_number": "270-956-0178",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPA-C"
    },
    "taxonomies": [
        {
            "code": "2865X1600X",
            "taxonomy_group": "",
            "desc": "Military Hospital, Military General Acute Care Hospital. Operational (Transportable)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Campbell, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2010; 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.