NPIMap

Keller Army Community Hospital

Organization Active NPI Military/U.S. Coast Guard Outpatient Clinic/Center · Fort Dix, NJ

NPI 1275747149 · NPPES record last updated Dec 20, 2012

Key facts

NPI
1275747149
Entity type
Organization (NPI type 2)
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X
Legal business name
KELLER ARMY COMMUNITY HOSPITAL
Practice address
5631 Baltimore St
Fort Dix, NJ 08640-5440
Phone
(845) 938-4034
NPI assigned
May 10, 2007
Organization subpart
Yes
Parent organization (as reported)
KELLER ARMY COMMUNITY HOSPITAL

Authorized official

Name
Kenneth Tuffy
Title
Ubo Manager
Phone
(845) 938-8239

Corporate family (same tax ID) 12

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

National Provider Directory

Tax ID family
Ach Keller-West Point (13 organizations share this tax ID)
Part of
Ach Keller-West Point

Specialties & licenses

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

Addresses

Primary practice location

5631 Baltimore St
Fort Dix, NJ 08640-5440

Mailing address

900 Washington Rd
Attn McUd-RMD-Ubo
West Point, NY 10996-1109
Phone (845) 938-8239

Other identifiers

IdentifierTypeStateIssuer
1528161916OtherPARENT FACILITY NPI

Other names

  • MILLS TROOP CLINIC-FT. DIX Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 20, 2012.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355961600000",
    "number": "1275747149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WASHINGTON RD",
            "address_2": "ATTN MCUD-RMD-UBO",
            "city": "WEST POINT",
            "state": "NY",
            "postal_code": "109961109",
            "telephone_number": "845-938-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5631 BALTIMORE ST",
            "city": "FORT DIX",
            "state": "NJ",
            "postal_code": "086405440",
            "telephone_number": "845-938-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLER ARMY COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KELLER ARMY COMMUNITY HOSPITAL",
        "enumeration_date": "2007-05-10",
        "last_updated": "2012-12-20",
        "status": "A",
        "authorized_official_last_name": "TUFFY",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "UBO MANAGER",
        "authorized_official_telephone_number": "845-938-8239"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARENT FACILITY NPI",
            "identifier": "1528161916",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MILLS TROOP CLINIC-FT. DIX",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Dix, NJ

All providers in Fort Dix, NJ · Military/U.S. Coast Guard Outpatient Clinic/Center in New Jersey

Sources for this page

Verify at the official NPI Registry.