NPIMap

Organization Active NPI

Ahc Moncrief-Jackson

  • Military General Acute Care Hospital
  • Fort Jackson, SC
National Provider Identifier
1386652956
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military General Acute Care HospitalTaxonomy code 2865M2000X
Legal business name
AHC MONCRIEF-JACKSON
Practice address
4500 Stuart St
Fort Jackson, SC 29207-5720
Phone
(803) 751-2160
NPI assigned
Aug 3, 2006
Organization subpart
Yes
Parent organization
AHC MONCRIEF-JACKSONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
Mariye McCray
Title
Ubo Manager
Phone
(803) 751-0472

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X SC
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center 261QM1101X SC
Military General Acute Care Hospital 2865M2000X SC Primary

Addresses

Primary practice location

4500 Stuart St
Fort Jackson, SC 29207-5720

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
42-22802OtherNCPDP
AN2598588OtherMEDCO ID

Other names 1

  • ACH MONCRIEF-JACKSON Other name

National Provider Directory

National Provider Directory
Tax ID family
Moncrief Army Community Hospital11 organizations share this tax ID, including this one
Part of
Moncrief Army Community Hospital

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1386652956",
    "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",
            "fax_number": "803-751-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 STUART ST",
            "city": "FORT JACKSON",
            "state": "SC",
            "postal_code": "292075720",
            "telephone_number": "803-751-2160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHC MONCRIEF-JACKSON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AHC MONCRIEF-JACKSON",
        "enumeration_date": "2006-08-03",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "MCCRAY",
        "authorized_official_first_name": "MARIYE",
        "authorized_official_title_or_position": "UBO MANAGER",
        "authorized_official_telephone_number": "803-751-0472"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1101X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "2865M2000X",
            "taxonomy_group": "",
            "desc": "Military Hospital, Military General Acute Care Hospital",
            "state": "SC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "42-22802",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCO ID",
            "identifier": "AN2598588",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ACH MONCRIEF-JACKSON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Jackson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2025; 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.