NPIMap

Organization Active NPI

Moncrief Army Community Hospital

Doing business as TMC Con-1-2-4-Jackson

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Columbia, SC
National Provider Identifier
1285840512
Registry record updated Apr 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
MONCRIEF ARMY COMMUNITY HOSPITAL
Doing business as
TMC Con-1-2-4-Jackson
Practice address
4500 Stuart St
BLDG 4575
Columbia, SC 29207-5700
Phone
(803) 751-2310
NPI assigned
May 15, 2007
Last updated
Apr 8, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MONCRIEF ARMY COMMUNITY HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 8, 2015

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

Authorized official

Name
Willie Warren
Title
Chief, Ubo
Phone
(803) 751-0472

Specialties & licenses 1

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

Addresses

Primary practice location

4500 Stuart St
BLDG 4575
Columbia, SC 29207-5700

Mailing address

4500 Stuart St
Box 497
Fort Jackson, SC 29207-5720
Phone (803) 751-0472

Other names 1

  • TMC CON-1-2-4-JACKSON Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ahc Moncrief-Jackson11 organizations share this tax ID, including this one
Part of
Ahc Moncrief-Jackson

Other organizations with this tax ID 10

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428451200000",
    "number": "1285840512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 STUART ST",
            "address_2": "BOX 497",
            "city": "FORT JACKSON",
            "state": "SC",
            "postal_code": "292075720",
            "telephone_number": "803-751-0472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 STUART ST",
            "address_2": "BLDG 4575",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292075700",
            "telephone_number": "803-751-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONCRIEF ARMY COMMUNITY HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONCRIEF ARMY COMMUNITY HOSPITAL",
        "enumeration_date": "2007-05-15",
        "last_updated": "2015-04-08",
        "status": "A",
        "authorized_official_last_name": "WARREN",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_title_or_position": "CHIEF, UBO",
        "authorized_official_telephone_number": "803-751-0472"
    },
    "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": "TMC CON-1-2-4-JACKSON",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; 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.