NPIMap

Organization Active NPI

Ahc McDonald-Eustis

  • Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
  • Fort Eustis, VA
National Provider Identifier
1922199066
Registry record updated May 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military and U.S. Coast Guard Ambulatory Procedure Clinic/CenterTaxonomy code 261QM1101X
Legal business name
AHC MCDONALD-EUSTIS
Practice address
579 Jefferson Ave
Fort Eustis, VA 23604
Phone
(757) 314-7500
NPI assigned
Sep 27, 2006
Organization subpart
Yes
Parent organization
AHC MCDONALD-EUSTISAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 22, 2025

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

Authorized official

Name
NA'Keesha De'Bose
Title
Ubo Manager
Phone
(757) 314-7500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center 261QM1101X Primary

Addresses

Primary practice location

579 Jefferson Ave
Fort Eustis, VA 23604

Mailing address

579 Jefferson Ave
Attn Ubo
Fort Eustis, VA 23604
Phone (757) 314-7770

Other identifiers 3

IdentifierTypeStateIssuer
007316OtherVATRIGON PROVIDER NUMBER
266569OtherVABLUE SHIELD PROVIDER NUMB
4830419OtherNCPDP

Other names 1

  • AHC MCDONALD-EUSTIS Other name

National Provider Directory

National Provider Directory
Tax ID family
Ahc McDonald-Eustis12 organizations share this tax ID, including this one
Part of
Ahc McDonald-Eustis

Other organizations with this tax ID 11

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": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747872000000",
    "number": "1922199066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 JEFFERSON AVE",
            "address_2": "ATTN UBO",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "23604",
            "telephone_number": "757-314-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 JEFFERSON AVE",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "23604",
            "telephone_number": "757-314-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AHC MCDONALD-EUSTIS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AHC MCDONALD-EUSTIS",
        "enumeration_date": "2006-09-27",
        "last_updated": "2025-05-22",
        "certification_date": "2025-05-22",
        "status": "A",
        "authorized_official_last_name": "DE'BOSE",
        "authorized_official_first_name": "NA'KEESHA",
        "authorized_official_title_or_position": "UBO MANAGER",
        "authorized_official_telephone_number": "757-314-7500"
    },
    "taxonomies": [
        {
            "code": "261QM1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military/U.S. Coast Guard Outpatient",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1101X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON PROVIDER NUMBER",
            "identifier": "007316",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMB",
            "identifier": "266569",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4830419",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AHC MCDONALD-EUSTIS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fort Eustis, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.