NPIMap

Organization Active NPI

62 Medical Group

  • Primary Care Clinic/Center
  • McChord AFB, WA
National Provider Identifier
1801837398
Registry record updated Jun 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
62 MEDICAL GROUP
Practice address
690 Barnes Blvd
Attn: SGHC
McChord AFB, WA 98438
Phone
(253) 982-9918
Fax
(253) 982-0283
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2008

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

Authorized official

Name
Tessie M Rios
Title
Credentials Manager
Phone
(253) 982-9918

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

690 Barnes Blvd
Attn: SGHC
McChord AFB, WA 98438

Mailing address

690 Barnes Blvd
Attn: SGHC
McChord AFB, WA 98438
Phone (253) 982-9918

National Provider Directory

National Provider Directory
Tax ID family
62 Medical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1801837398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "690 BARNES BLVD",
            "address_2": "ATTN: SGHC",
            "city": "MCCHORD AFB",
            "state": "WA",
            "postal_code": "98438",
            "telephone_number": "253-982-9918",
            "fax_number": "253-982-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 BARNES BLVD",
            "address_2": "ATTN: SGHC",
            "city": "MCCHORD AFB",
            "state": "WA",
            "postal_code": "98438",
            "telephone_number": "253-982-9918",
            "fax_number": "253-982-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "62 MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "RIOS",
        "authorized_official_first_name": "TESSIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALS MANAGER",
        "authorized_official_telephone_number": "253-982-9918"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McChord AFB, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.