NPIMap

Organization Active NPI

Uscg Air Station Port Angeles Medcial/Dental Clinic

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Washington, DC
National Provider Identifier
1477538361
Registry record updated Aug 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
USCG AIR STATION PORT ANGELES MEDCIAL/DENTAL CLINIC
Practice address
Commandant Uscg HQ (CG-1122)
2100 2ND Street
Washington, DC 20593-0001
Phone
(202) 267-0801
NPI assigned
Dec 13, 2005
Reactivated
Aug 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2010

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

Authorized official

Name
Stephen J Kinsley, M.D.
Title
Senior Health Services Officer
Phone
(360) 417-5894

Specialties & licenses 1

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

Addresses

Primary practice location

Commandant Uscg HQ (CG-1122)
2100 2ND Street
Washington, DC 20593-0001

Mailing address

Commandant Uscg HQ (CG-1122)
2100 2ND Street
Washington, DC 20593-0001
Phone (202) 267-0801

Other names 1

  • Gershowitz Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Uscg Clinic St Petersburg65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Locations

Commandant Uscg Hq Cg1122
Washington, DC 20593
Phone (202) 267-0801

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": "1134432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282089600000",
    "number": "1477538361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "COMMANDANT USCG HQ (CG-1122)",
            "address_2": "2100 2ND STREET",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205930001",
            "telephone_number": "202-267-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "COMMANDANT USCG HQ (CG-1122)",
            "address_2": "2100 2ND STREET",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "205930001",
            "telephone_number": "202-267-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "USCG AIR STATION PORT ANGELES MEDCIAL/DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-13",
        "last_updated": "2010-08-18",
        "deactivation_date": "2008-06-03",
        "reactivation_date": "2010-08-17",
        "status": "A",
        "authorized_official_last_name": "KINSLEY",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "SENIOR HEALTH SERVICES OFFICER",
        "authorized_official_telephone_number": "360-417-5894",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gershowitz Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; 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.