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USADC PHY EXAM STA-JACKSON
NPI 1902002462
Clinic/Center - Military/U.S. Coast Guard Outpatient in Fort Jackson, SC

Active since June 22, 2007
1890 WASHINGTON ROAD, FORT JACKSON, SC 29207(803) 751-2021 Get Directions Write a Review

NPPES record last updated: April 8, 2015. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Usadc Phy Exam Sta-jackson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

USADC PHY EXAM STA-JACKSON (NPI 1902002462) is a healthcare organization registered as a military/u.s. coast guard outpatient in Fort Jackson, South Carolina and active in the NPI registry since June 2007. The organization lists Willie Warren, Chief, Ubo, as its authorized official.

NPPES Registry Identity

NPI1902002462
Entity TypeOrganization
Primary Taxonomy261QM1100X
Legal Business NameMONCRIEF ARMY COMMUNITY HOSPITAL
Location Address1890 WASHINGTON ROADFort Jackson, SC 29207
Mailing Address4500 Stuart St, Box 497Fort Jackson, SC 29207-5720 · (803) 751-0472
Phone(803) 751-2021
Organization SubpartYes
Authorized OfficialWillie WarrenChief, Ubo · (803) 751-0472
Enumeration DateJune 22, 2007
Last NPPES UpdateApril 8, 2015
✔ NPI 1902002462 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Military/U.S. Coast Guard OutpatientAmbulatory Health Care Facilities
Taxonomy Code261QM1100X
Definition
The Defense Health Program or U.S. Coast Guard funded fixed facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A fixed facility is a non-temporary, non-deployed facility. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the fixed facility. It includes, as examples, the institutional portion of outpatient encounters (except Ambulatory Procedure Visits), supplies issued (e.g., glasses, ostomy supplies, crutches), and radiology and laboratory studies. Does not include items issued directly to a patient from an outpatient pharmacy or patient transport.
1890 WASHINGTON ROAD, Fort Jackson, SC 29207
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Other Names 1

Doing Business AsUsadc Phy Exam Sta-jackson

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Moncrief Army Community Hospital's NPI number?

The NPI number for Moncrief Army Community Hospital is 1902002462. It was assigned to this organization in the NPPES registry on June 22, 2007. The provider is doing business as Usadc Phy Exam Sta-Jackson.

Where is Moncrief Army Community Hospital located?

Moncrief Army Community Hospital is located at 1890 Washington Road, Fort Jackson, SC 29207. The listed phone number is (803) 751-2021.

What is Moncrief Army Community Hospital's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Military/U.S. Coast Guard Outpatient, with taxonomy code 261QM1100X.

When was this NPI record last updated?

The NPPES record for Moncrief Army Community Hospital was last updated on April 8, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.