79TH Medical Group Malcolm Grow Medical Center

Primary specialty

Military HospitalTaxonomy code 286500000X

License

RN64518 Issued in DC

Legal business name

79TH MEDICAL GROUP MALCOLM GROW MEDICAL CENTER

Practice address

1050 W Perimeter Rd
Malcolm Grow Medical Center
Andrews Air Force Base, MD 20762-6601

Phone

(240) 857-4951

Fax

(240) 857-7138

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Natalie Yvette Giscombe, REGISTERED NURSE

Title

Adult Nurse Practitioner

Phone

(240) 857-4951

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213315200000",
    "number": "1972643401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11423 PLENTY GATES CT",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206015601",
            "telephone_number": "301-645-3357",
            "fax_number": "240-857-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 W PERIMETER RD",
            "address_2": "MALCOLM GROW MEDICAL CENTER",
            "city": "ANDREWS AIR FORCE BASE",
            "state": "MD",
            "postal_code": "207626601",
            "telephone_number": "240-857-4951",
            "fax_number": "240-857-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "79TH MEDICAL GROUP MALCOLM GROW MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-06-13",
        "status": "A",
        "authorized_official_last_name": "GISCOMBE",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "YVETTE",
        "authorized_official_title_or_position": "ADULT NURSE PRACTITIONER",
        "authorized_official_telephone_number": "240-857-4951",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "REGISTERED NURSE"
    },
    "taxonomies": [
        {
            "code": "286500000X",
            "taxonomy_group": "",
            "desc": "Military Hospital",
            "state": "DC",
            "license": "RN64518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ardythe K Ellison, RN, MSN, CNM
• Stephan Klaus Hanses, M.D.
• Joseph and Bass Eye Associates PA
• Kathryn E Kanzler, PSY.D., ABPP
• Corazon Lego, RN

• Military Hospital in Andrews Air Force Base, MD
• Providers in Andrews Air Force Base, MD by specialty
• Military Hospital in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; 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.