NPIMap

Organization Active NPI

AMC Eisenhower

  • Military General Acute Care Hospital
  • Fort Gordon, GA
National Provider Identifier
1578660742
Registry record updated May 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military General Acute Care HospitalTaxonomy code 2865M2000X
Legal business name
AMC EISENHOWER
Practice address
300 W Hospital Rd BLDG W
Fort Gordon, GA 30905-5741
Phone
(706) 787-5811
NPI assigned
Sep 20, 2006
Last updated
May 21, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
AMC EISENHOWERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2025

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

Authorized official

Name
Kimberly Brown
Title
Ubo Manager
Phone
(706) 787-7172

Specialties & licenses 3

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

Addresses

Primary practice location

300 W Hospital Rd BLDG W
Fort Gordon, GA 30905-5741

Mailing address

300 W Hospital Rd BLDG W
Attn MCHF-Pad
Fort Gordon, GA 30905-5741
Phone (706) 787-1125

Other identifiers 2

IdentifierTypeStateIssuer
1497854160/1146643OtherPHARMACY NPI2/NCPDP
AN2598588OtherMEDCO

Other names 1

  • AMC EISENHOWER-GORDON Other name

National Provider Directory

National Provider Directory
Tax ID family
Eisenhower Army Medical Center16 organizations share this tax ID, including this one
Part of
Eisenhower Army Medical Center

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747785600000",
    "number": "1578660742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD BLDG W",
            "address_2": "ATTN MCHF-PAD",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W HOSPITAL RD BLDG W",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055741",
            "telephone_number": "706-787-5811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMC EISENHOWER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AMC EISENHOWER",
        "enumeration_date": "2006-09-20",
        "last_updated": "2025-05-21",
        "certification_date": "2025-05-21",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "UBO MANAGER",
        "authorized_official_telephone_number": "706-787-7172"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1101X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2865M2000X",
            "taxonomy_group": "",
            "desc": "Military Hospital, Military General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY NPI2/NCPDP",
            "identifier": "1497854160/1146643",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCO",
            "identifier": "AN2598588",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AMC EISENHOWER-GORDON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Gordon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.