NPIMap

Organization Active NPI

Blanchfield Army Community Hospital

Doing business as Screaming Eagle Medical Home-Campb

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Clarksville, TN
National Provider Identifier
1275846263
Registry record updated Jan 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
BLANCHFIELD ARMY COMMUNITY HOSPITAL
Doing business as
Screaming Eagle Medical Home-Campb
Practice address
647 Dunlop LN
Gateway Medical Center Medical Office BLDG One
Clarksville, TN 37040-5165
Phone
(270) 461-5019
NPI assigned
Jul 19, 2010
Last updated
Jan 3, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
BLANCHFIELD ARMY COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 3, 2013

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

Authorized official

Name
Liza J O'Neal
Title
C, Pad
Phone
(270) 798-8491

Specialties & licenses 1

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

Addresses

Primary practice location

647 Dunlop LN
Gateway Medical Center Medical Office BLDG One
Clarksville, TN 37040-5165

Mailing address

650 Joel Dr
Attn Ubo
Fort Campbell, KY 42223-5318
Phone (270) 798-8286

Other names 1

  • SCREAMING EAGLE MEDICAL HOME-CAMPB Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Blanchfield Army Community Hospital24 organizations share this tax ID, including this one
Part of
Blanchfield Army Community Hospital

Other organizations with this tax ID 23

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

View all 23

Locations

647 Dunlop Ln
Ofc
Clarksville, TN 37040
Phone (270) 461-5019

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357171200000",
    "number": "1275846263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "address_2": "ATTN UBO",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422235318",
            "telephone_number": "270-798-8286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647 DUNLOP LN",
            "address_2": "GATEWAY MEDICAL CENTER MEDICAL OFFICE BLDG ONE",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370405165",
            "telephone_number": "270-461-5019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
        "enumeration_date": "2010-07-19",
        "last_updated": "2013-01-03",
        "status": "A",
        "authorized_official_last_name": "O'NEAL",
        "authorized_official_first_name": "LIZA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "C, PAD",
        "authorized_official_telephone_number": "270-798-8491"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCREAMING EAGLE MEDICAL HOME-CAMPB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.