Active NPI
Jeffrey S. Macintire, MD
- Family Medicine Physician
- Fort Campbell, KY
National Provider Identifier
1407897556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25175
- Practice address
- USA Meddac Bach
650 Joel Drive
Fort Campbell, KY 42223 - Phone
- (931) 270-8764
- NPI assigned
- Jun 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25175 | TN | Primary |
Addresses
Primary practice location
USA Meddac Bach
650 Joel Drive
Fort Campbell, KY 42223
Mailing address
Blanchfield Army Community Hospital
650 Joel Drive
Fort Campbell, KY 42223
Phone (931) 270-8764
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25175 | TN | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1407897556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BLANCHFIELD ARMY COMMUNITY HOSPITAL",
"address_2": "650 JOEL DRIVE",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "42223",
"telephone_number": "931-270-8764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "USA MEDDAC BACH",
"address_2": "650 JOEL DRIVE",
"city": "FORT CAMPBELL",
"state": "KY",
"postal_code": "42223",
"telephone_number": "931-270-8764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACINTIRE",
"first_name": "JEFFREY",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "25175",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Campbell, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.