4TH Medgrp-Seymour Johnson

Primary specialty

Military/U.S. Coast Guard PharmacyTaxonomy code 332000000X

Legal business name

4TH MEDGRP-SEYMOUR JOHNSON

Doing business as

DoD SEY-JOHN ePhcy

Practice address

2803 Medical Campus Drive
Seymour Johnson AFB, NC 27531

Phone

(919) 722-8257

NPI assigned

Jul 28, 2014

Last updated

May 30, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

4TH MEDGRP-SEYMOUR JOHNSONAs reported in NPPES

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

Authorized official

Name

Tiffany Lighthill

Title

Ncoic, Uniform Business Office

Phone

(919) 722-8257

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DoD SEY-JOHN ePhcy Doing business as

Tax ID family

4TH Medgrp-Seymour Johnson2 organizations share this tax ID, including this one

Part of

4TH Medgrp-Seymour Johnson

Other organizations with this tax ID 1

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

• Seymour Johnson Medical Group

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Seymour Johnson AFB, NC
  • NPI 1831173558
  NPD tax ID

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748563200000",
    "number": "1811305477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2803 MEDICAL CAMPUS DRIVE",
            "city": "SEYMOUR JOHNSON AFB",
            "state": "NC",
            "postal_code": "27531",
            "telephone_number": "919-722-1811",
            "fax_number": "919-722-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2803 MEDICAL CAMPUS DRIVE",
            "city": "SEYMOUR JOHNSON AFB",
            "state": "NC",
            "postal_code": "27531",
            "telephone_number": "919-722-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4TH MEDGRP-SEYMOUR JOHNSON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "4TH MEDGRP-SEYMOUR JOHNSON",
        "enumeration_date": "2014-07-28",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A",
        "authorized_official_last_name": "LIGHTHILL",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "NCOIC, UNIFORM BUSINESS OFFICE",
        "authorized_official_telephone_number": "919-722-8257"
    },
    "taxonomies": [
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2147035",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DoD SEY-JOHN ePhcy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DoD SEY-JOHN ePhcy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Isaiah Gary Allison
• Ryan Ashworth, MS, ATC, PMP
• Anthony Shawn Bankes, M.D.
• Cameron Thomas Beckham, PA-C
• Chelsea Berghorn, MS, LAT, ATC, CSCS

• Military/U.S. Coast Guard Pharmacy in Seymour Johnson AFB, NC
• Providers in Seymour Johnson AFB, NC by specialty
• Military/U.S. Coast Guard Pharmacy in North Carolina

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