NPIMap

Organization Active NPI

Kenner Army Health Clinic

Doing business as Usadc Ft. Lee Col Bull

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fort Lee, VA
National Provider Identifier
1689879330
Registry record updated Jan 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
KENNER ARMY HEALTH CLINIC
Doing business as
Usadc Ft. Lee Col Bull
Practice address
2601 C Ave
Fort Lee, VA 23801-1717
Phone
(804) 734-9000
NPI assigned
Jun 20, 2007
Last updated
Jan 30, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
KENNER ARMY HEALTH CLINICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 30, 2014

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

Authorized official

Name
Carlos Rodriguez-Rosado
Title
Ncoic Pad
Phone
(804) 734-9299

Specialties & licenses 1

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

Addresses

Primary practice location

2601 C Ave
Fort Lee, VA 23801-1717

Mailing address

700 24TH St
Attn Pad
Fort Lee, VA 23801-1716
Phone (804) 734-9306

Other names 1

  • USADC FT. LEE COL BULL Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Walter Reed National Military Med Center9 organizations share this tax ID, including this one
Part of
Walter Reed National Military Med Center

Other organizations with this tax ID 8

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

Locations

2601 C Ave
Fort Lee, VA 23801
Phone (804) 734-9607

NPI Registry JSON

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391040000000",
    "number": "1689879330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 24TH ST",
            "address_2": "ATTN PAD",
            "city": "FORT LEE",
            "state": "VA",
            "postal_code": "238011716",
            "telephone_number": "804-734-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 C AVE",
            "city": "FORT LEE",
            "state": "VA",
            "postal_code": "238011717",
            "telephone_number": "804-734-9000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNER ARMY HEALTH CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENNER ARMY HEALTH CLINIC",
        "enumeration_date": "2007-06-20",
        "last_updated": "2014-01-30",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ-ROSADO",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_title_or_position": "NCOIC PAD",
        "authorized_official_telephone_number": "804-734-9299"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USADC FT. LEE COL BULL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lee, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2014; 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.