NPIMap

Organization Active NPI

Kimbrough Acc Military MTF

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Ft Myer, VA
National Provider Identifier
1467665877
Registry record updated Apr 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
KIMBROUGH ACC MILITARY MTF
Doing business as
AHC ANDREW RADER-MYER-HENDERSN
Practice address
401 Carpenter Rd
Ft Myer, VA 22211-1009
Phone
(301) 677-8800
NPI assigned
May 8, 2007
Organization subpart
Yes
Parent organization
KIMBROUGH ACC MILITARY MTFAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 1, 2015

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

Authorized official

Name
Terri Kimbrow
Title
Ubo Manager
Phone
(301) 677-8512

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X Primary
Military/U.S. Coast Guard Pharmacy 332000000X

Addresses

Primary practice location

401 Carpenter Rd
Ft Myer, VA 22211-1009

Mailing address

2480 Llewellyn Ave
CDR Usameddac MCXR-BD Ste 5800
Fort Meade, MD 20755-7081
Phone (301) 677-8253

Other identifiers 1

IdentifierTypeStateIssuer
1164507703OtherPARENT FACILITY NPI 2 EFF 1 OCT 10

Other names 1

  • AHC ANDREW RADER-MYER-HENDERSN Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ft Meade Meddac25 organizations share this tax ID, including this one
Part of
Ft Meade Meddac

Other organizations with this tax ID 24

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

View all 24

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1467665877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "address_2": "CDR USAMEDDAC MCXR-BD STE 5800",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "207557081",
            "telephone_number": "301-677-8253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 CARPENTER RD",
            "city": "FT MYER",
            "state": "VA",
            "postal_code": "222111009",
            "telephone_number": "301-677-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBROUGH ACC MILITARY MTF",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KIMBROUGH ACC MILITARY MTF",
        "enumeration_date": "2007-05-08",
        "last_updated": "2015-04-01",
        "status": "A",
        "authorized_official_last_name": "KIMBROW",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "UBO MANAGER",
        "authorized_official_telephone_number": "301-677-8512"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARENT FACILITY NPI 2 EFF 1 OCT 10",
            "identifier": "1164507703",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AHC ANDREW RADER-MYER-HENDERSN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ft Myer, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.