NPIMap

Organization Active NPI

Creech Aid Station

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Indian Springs, NV
National Provider Identifier
1942439476
Registry record updated Jul 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military/U.S. Coast Guard Outpatient Clinic/CenterTaxonomy code 261QM1100X
Legal business name
CREECH AID STATION
Practice address
2D Street BLDG #54
Indian Springs, NV 89018
Phone
(702) 404-1142
NPI assigned
Jul 6, 2009
Organization subpart
Yes
Parent organization
MIKE O'CALLAGHAN FEDERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 6, 2009

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

Authorized official

Name
Mr. Christopher Douglas Eaton
Title
Uniform Business Office Program MGR
Phone
(703) 681-6303

Specialties & licenses 1

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

Addresses

Primary practice location

2D Street BLDG #54
Indian Springs, NV 89018

Mailing address

4700 Las Vegas Blvd N
Nellis Afb, NV 89191-6600
Phone (702) 653-2015

Other identifiers 1

IdentifierTypeStateIssuer
2975742OtherNVNCPDP

Other names 1

  • 99th Med Gp Other name

National Provider Directory

National Provider Directory
Tax ID family
99TH Medical Group - Mike O'Callaghan Federal Hospital3 organizations share this tax ID, including this one
Part of
99TH Medical Group - Mike O'Callaghan Federal Hospital

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": "1246838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246838400000",
    "number": "1942439476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 LAS VEGAS BLVD N",
            "city": "NELLIS AFB",
            "state": "NV",
            "postal_code": "891916600",
            "telephone_number": "702-653-2015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2D STREET BLDG #54",
            "city": "INDIAN SPRINGS",
            "state": "NV",
            "postal_code": "89018",
            "telephone_number": "702-404-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREECH AID STATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIKE O'CALLAGHAN FEDERAL HOSPITAL",
        "enumeration_date": "2009-07-06",
        "last_updated": "2009-07-06",
        "status": "A",
        "authorized_official_last_name": "EATON",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "UNIFORM BUSINESS OFFICE PROGRAM MGR",
        "authorized_official_telephone_number": "703-681-6303",
        "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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2975742",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "99th Med Gp",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Indian Springs, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2009; 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.