Madigan Army Medical Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05743 Issued in MD

Legal business name

MADIGAN ARMY MEDICAL CENTER

Practice address

437 Cabrillo St
Suite Aia -US Army Health Clinic
Presido of Monterey, CA 93944

Phone

(831) 242-7589

Fax

(831) 242-6620

NPI assigned

Apr 6, 2006

Organization subpart

No

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

Authorized official

Name

Patricia Barnhart

Title

Credentials Manager

Phone

(253) 968-2252

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• california medical detachment Other name

Locations

Subparts reporting this organization as parent 2

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

• Madigan Army Medical Center

  dba Gourley VA DoD Clinic

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Marina, CA
  • NPI 1497270342
  NPPES parent name
• Madigan Army Medical Ctr

  dba Usadc Presidio of Monterrey

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Monterey, CA
  • NPI 1255537510
  NPPES parent name

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1205898871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 REID ST.",
            "address_2": "ATTN. MCHJ-QCR",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984313278",
            "telephone_number": "253-986-2252",
            "fax_number": "253-986-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "437 CABRILLO ST",
            "address_2": "SUITE AIA -US ARMY HEALTH CLINIC",
            "city": "PRESIDO OF MONTEREY",
            "state": "CA",
            "postal_code": "93944",
            "telephone_number": "831-242-7589",
            "fax_number": "831-242-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADIGAN ARMY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "BARNHART",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "CREDENTIALS MANAGER",
        "authorized_official_telephone_number": "253-968-2252"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "05743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE",
            "identifier": "04753",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "california medical detachment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.