NPIMap

Organization Active NPI

Kimbrough Acc Military MTF

Doing business as Ahc McNair-Myer-Henderson Hall

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Washington, DC
National Provider Identifier
1689888455
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 McNair-Myer-Henderson Hall
Practice address
103 3Rd Ave
Building 58
Washington, DC 20319-5058
Phone
(301) 677-8800
NPI assigned
May 10, 2007
Last updated
Apr 1, 2015By the provider in NPPES
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

103 3Rd Ave
Building 58
Washington, DC 20319-5058

Mailing address

2480 Llewellyn Ave
CDR Usameddac MCXR-BD Ste 5800
Fort Meade, MD 20755-7081
Phone (301) 677-8800

Other identifiers 2

IdentifierTypeStateIssuer
AN2598588OtherMEDCO
1164507703OtherPARENT FACILITY NPI 2 EFF 1 OCT 10

Other names 1

  • AHC MCNAIR-MYER-HENDERSON HALL 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

Locations

103 3rd Ave
Bldg 58
Washington, DC 20319
Phone (301) 677-8800

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427846400000",
    "number": "1689888455",
    "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": "301-677-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 3RD AVE",
            "address_2": "BUILDING 58",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "203195058",
            "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": "2007-05-10",
        "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": "MEDCO",
            "identifier": "AN2598588",
            "state": null
        },
        {
            "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 MCNAIR-MYER-HENDERSON HALL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.