US Navy

Primary specialty

Military Outpatient Operational (Transportable) Component Clinic/CenterTaxonomy code 261QM1102X

Legal business name

US NAVY

Practice address

Camp Leijune
Jacksonvill, NC 28460

Phone

(910) 440-4460

NPI assigned

Feb 17, 2021

Last updated

Feb 17, 2021By 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

Mr. Jacob Wayne Akins, SOIDC

Title

Idc

Phone

(903) 821-0599

Specialties & licenses 1

Addresses

Other names 1

• 2nd Marine Raider BN Other name

Electronic endpoints 1

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1245823608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 OLD DORCHESTER RD",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750927022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CAMP LEIJUNE",
            "city": "JACKSONVILL",
            "state": "NC",
            "postal_code": "28460",
            "telephone_number": "910-440-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "US NAVY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-02-17",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "AKINS",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "IDC",
        "authorized_official_telephone_number": "903-821-0599",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "SOIDC"
    },
    "taxonomies": [
        {
            "code": "261QM1102X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military Outpatient Operational (Transportable) Component",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Altha",
            "affiliation": "N",
            "endpointDescription": "US Navy Medical Program",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Patient orders",
            "address_1": "Camp Leijune",
            "city": "Jacksonvill",
            "state": "NC",
            "country_code": "US",
            "postal_code": "28460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "2nd Marine Raider BN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.