NPIMap

Organization Active NPI

Madigan Army Medical Ctr

Doing business as Okubo Family Practice Clinic-Ft Lewis

  • Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center
  • North Fort Lewis, WA
National Provider Identifier
1992910806
Registry record updated Apr 13, 2015
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
MADIGAN ARMY MEDICAL CTR
Doing business as
Okubo Family Practice Clinic-Ft Lewis
Practice address
BLDG 11582 17TH and C Street
North Fort Lewis, WA 98433
Phone
(253) 966-1991
NPI assigned
May 14, 2007
Organization subpart
Yes
Parent organization
MADIGAN ARMY MEDICAL CTRAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Authorized official

Name
Karen Mady
Title
TPC Manager
Phone
(253) 968-6598

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Military/U.S. Coast Guard Outpatient Clinic/Center 261QM1100X
Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center 261QM1101X Primary
Military/U.S. Coast Guard Pharmacy 332000000X

Addresses

Primary practice location

BLDG 11582 17TH and C Street
North Fort Lewis, WA 98433

Mailing address

9040A Jackson Ave
Attn: MCHJ-Csa-U
Tacoma, WA 98431-0001
Phone (253) 968-6598

Other identifiers 2

IdentifierTypeStateIssuer
AN2598588OtherMEDCO
1841390077OtherPARENT FACILITY NPI

Other names 1

  • OKUBO FAMILY PRACTICE CLINIC-FT LEWIS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Madigan Army Medical Ctr33 organizations share this tax ID, including this one
Part of
Madigan Army Medical Ctr

Other organizations with this tax ID 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1992910806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040A JACKSON AVE",
            "address_2": "ATTN: MCHJ-CSA-U",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001",
            "telephone_number": "253-968-6598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG 11582 17TH AND C STREET",
            "city": "NORTH FORT LEWIS",
            "state": "WA",
            "postal_code": "98433",
            "telephone_number": "253-966-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADIGAN ARMY MEDICAL CTR",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MADIGAN ARMY MEDICAL CTR",
        "enumeration_date": "2007-05-14",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "MADY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "TPC MANAGER",
        "authorized_official_telephone_number": "253-968-6598"
    },
    "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
        },
        {
            "code": "332000000X",
            "taxonomy_group": "",
            "desc": "Military/U.S. Coast Guard Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCO",
            "identifier": "AN2598588",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARENT FACILITY NPI",
            "identifier": "1841390077",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OKUBO FAMILY PRACTICE CLINIC-FT LEWIS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in North Fort Lewis, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.