NPIMap

Organization Active NPI

Womack Army Medical Center

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fort Bragg, NC
National Provider Identifier
1295941664
Registry record updated Feb 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
WOMACK ARMY MEDICAL CENTER
Practice address
44 Bastogne Dr
Fort Bragg, NC 28310-0001
Phone
(910) 907-9262
NPI assigned
May 15, 2007
Organization subpart
Yes
Parent organization
WOMACK ARMY MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2013

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

Authorized official

Name
Barbara Black
Title
Ubo Manager
Phone
(910) 907-8537

Specialties & licenses 1

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

Addresses

Primary practice location

44 Bastogne Dr
Fort Bragg, NC 28310-0001

Mailing address

2817 Reilly St
MCXC-Dbo-Ub Wamc Stop a
Fort Bragg, NC 28310-7324
Phone (910) 907-6693

Other identifiers 4

IdentifierTypeStateIssuer
0465YOtherBCBS PHARMACY ID
00539OtherBCBS UB-04 PROVIDER ID
1740377423OtherPARENT FACILITY NPI
0294AOtherBCBS CMS 1500 PROVIDER ID

Other names 1

  • CLARK CLINIC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Womack Army Medical Center28 organizations share this tax ID, including this one
Part of
Womack Army Medical Center

Other organizations with this tax ID 27

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

View all 27

Locations

44 Bastogne Dr
Fort Bragg, NC 28310

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": "1360540800000",
    "number": "1295941664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 REILLY ST",
            "address_2": "MCXC-DBO-UB WAMC STOP A",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283107324",
            "telephone_number": "910-907-6693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BASTOGNE DR",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMACK ARMY MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WOMACK ARMY MEDICAL CENTER",
        "enumeration_date": "2007-05-15",
        "last_updated": "2013-02-11",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "UBO MANAGER",
        "authorized_official_telephone_number": "910-907-8537"
    },
    "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": "BCBS PHARMACY ID",
            "identifier": "0465Y",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS UB-04 PROVIDER ID",
            "identifier": "00539",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARENT FACILITY NPI",
            "identifier": "1740377423",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CMS 1500 PROVIDER ID",
            "identifier": "0294A",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CLARK CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Bragg, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 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.