NPIMap

Organization Active NPI

Tricare Medical Clinic Chesapeake

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Portsmouth, VA
National Provider Identifier
1861538258
Registry record updated Nov 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
TRICARE MEDICAL CLINIC CHESAPEAKE
Practice address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone
(757) 953-5297
NPI assigned
Jan 30, 2007
Organization subpart
Yes
Parent organization
NAVAL MEDICAL CENTER PORTSMOUTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 13, 2017

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

Authorized official

Name
William M Condon
Title
Bumed Ubo
Phone
(240) 401-3643

Specialties & licenses 1

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

Addresses

Primary practice location

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Mailing address

1011 Eden Way N
Ste H
Chesapeake, VA 23320-2768
Phone (757) 953-6366

National Provider Directory

National Provider Directory
Tax ID family
Sentara Obici Surgery Ctr - Navy Resource Sharing21 organizations share this tax ID, including this one
Part of
Sentara Obici Surgery Ctr - Navy Resource Sharing

Other organizations with this tax ID 20

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

View all 20

Locations

1011 Eden Way N
Ste H
Chesapeake, VA 23320
Phone (757) 314-8999

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510531200000",
    "number": "1861538258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 EDEN WAY N",
            "address_2": "STE H",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233202768",
            "telephone_number": "757-953-6366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICARE MEDICAL CLINIC CHESAPEAKE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NAVAL MEDICAL CENTER PORTSMOUTH",
        "enumeration_date": "2007-01-30",
        "last_updated": "2017-11-13",
        "status": "A",
        "authorized_official_last_name": "CONDON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "BUMED UBO",
        "authorized_official_telephone_number": "240-401-3643"
    },
    "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 Portsmouth, VA

Sources for this page

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