NPIMap

Organization Active NPI

Branch Medical Clinic Indian Head

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Indian Head, MD
National Provider Identifier
1841498417
Registry record updated Dec 19, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
BRANCH MEDICAL CLINIC INDIAN HEAD
Practice address
4141 W Wilson Rd
Suite105
Indian Head, MD 20640-5162
Phone
(301) 744-4601
NPI assigned
Jul 5, 2007
Last updated
Dec 19, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
NAVAL HEALTH CLINIC PATUXENT RIVERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 19, 2017

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

Authorized official

Name
Mr. William Michael Condon
Title
Navy Medicine Ubo Program Manager
Phone
(240) 401-3643

Specialties & licenses 1

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

Addresses

Primary practice location

4141 W Wilson Rd
Suite105
Indian Head, MD 20640-5162

Mailing address

4141 W Wilson Rd
Suite105
Indian Head, MD 20640-5162

National Provider Directory

National Provider Directory
Tax ID family
Branch Medical Clinic Andrews7 organizations share this tax ID, including this one
Part of
Branch Medical Clinic Andrews

Other organizations with this tax ID 6

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

Locations

4141 W Wilson Rd
Ste 105
Indian Head, MD 20640
Phone (301) 744-4601

NPI Registry JSON

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1841498417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 W WILSON RD",
            "address_2": "SUITE105",
            "city": "INDIAN HEAD",
            "state": "MD",
            "postal_code": "206405162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 W WILSON RD",
            "address_2": "SUITE105",
            "city": "INDIAN HEAD",
            "state": "MD",
            "postal_code": "206405162",
            "telephone_number": "301-744-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCH MEDICAL CLINIC INDIAN HEAD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL HEALTH CLINIC PATUXENT RIVER",
        "enumeration_date": "2007-07-05",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "NAVY MEDICINE UBO PROGRAM MANAGER",
        "authorized_official_telephone_number": "240-401-3643",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Head, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.