Storm Loffa
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Fort Eisenhower, GA
NPI 1336834712 · NPPES record last updated Oct 31, 2023
Key facts
- NPI
- 1336834712
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 300 W Hospital Rd
Fort Eisenhower, GA 30905-5741 - Phone
- (706) 787-5811
- NPI assigned
- Apr 10, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251113001472 | GA | Order and Referring Only - Family Practice |
6800387283 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
300 W Hospital Rd
Fort Eisenhower, GA 30905-5741
Mailing address
300 W Hospital Rd
Fort Gordon, GA 30905-5741
Other providers in Fort Eisenhower, GA
- Ashley R Killings
- Laura Krause
- Nashunta Denise Lacey
- Matthew Lavengood
- Liberty Caitlyn Lester
- Jordan E Loftin
- Leilani Lopes-Haslam
- Juan Manuel Lopez
- Amy Loser
- Paige Macky
All providers in Fort Eisenhower, GA · Student in an Organized Health Care Education/Training Program in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.