EIELSON AFB MTF
NPI 1902867229
Clinic/Center - Military/U.S. Coast Guard Outpatient in Eielson Afb, AK

NPI Status: Active since March 28, 2006

Contact Information

2630 CENTRAL AVE
SUITE 1M07
EIELSON AFB, AK
ZIP 99702
Phone: (907) 377-6579

Get Directions Reviews

  • Organization
  • Clinic/Center
  • Military/U.S. Coast Guard Outpatient

About EIELSON AFB MTF

Eielson Afb Mtf is a provider established in Eielson Afb, Alaska operating as a Clinic/center with a focus in military/u.s. coast guard outpatient . The healthcare provider is registered in the NPI registry with number 1902867229 assigned on March 2006. The practitioner's primary taxonomy code is 261QM1100X. The provider is registered as an organization and their NPI record was last updated 10 years ago. The provider's other name is Eielson Afb Mtf. The authorized official of this NPI record is Theresa Marie Mitchell (Air Force Ubo Analyst)

NPI
1902867229
Provider Legal Name
354TH MEDICAL GROUP
Other Organization Name
EIELSON AFB MTF
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
2630 CENTRAL AVE SUITE 1M07 EIELSON AFB, AK 99702
Location Phone
(907) 377-6579
Mailing Address
2630 CENTRAL AVE SUITE 1M07 EIELSON AFB, AK 99702
Mailing Phone
(907) 377-6579
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-28-2006
Last Update Date
03-07-2014
Code Navigator

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Military/U.S. Coast Guard Outpatient

Taxonomy Code
261QM1100X
Type
Ambulatory Health Care Facilities
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1261QM1101XAmbulatory Health Care Facilities

Clinic/Center
Military and U.S. Coast Guard Ambulatory Procedure

 
2332000000XSuppliers

Military/U.S. Coast Guard Pharmacy

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

THERESA MARIE MITCHELL

Authorized Official Title
AIR FORCE UBO ANALYST
Authorized Official Phone
(703) 681-7613

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
02-02399OTHER (01)AKNCPDP

Reviews for EIELSON AFB MTF

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1902867229
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
29021661424
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 0 + 2 + 1 + 6 + 6 + 1 + 4 + 2 + 4 + 24 = 61
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 61 = 99

The NPI number 1902867229 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1598732364DR. THERESA ANN LAWSON PH.D.
Individual
Psychologist (Counseling)2630 CENTRAL AVE LIFE SKILLS SUPPORT CENTER
EIELSON AFB, AK 99702
(907) 377-3071
1275502312 JOLANDA JEANETTE COOK L.C.S.W.
Individual
Social Worker (Clinical)2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-4041
1477512853DR. HOLLY VOKOUN ELLENBERGER D.M.D.
Individual
Dentist (General Practice)2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6744
1316965957MRS. KAREN L MEDBURY MSW, LCSW
Individual
Social Worker (Clinical)2630 CENTRAL AVE SUITE 1
EIELSON AFB, AK 99702
(907) 377-4727
1851534184 ANGELIA DEANNE CALDER EMT-B, PHTLS, ACLS,
Individual
Military Health Care Provider (Independent Duty Medical Technicians)2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6629
1982830287MRS. JULIANNE MARIE LUJAN IDMT
Individual
Military Health Care Provider (Independent Duty Medical Technicians)2630 CENTRAL AVE 354 MDOS FLIGHT MEDICINE CLINIC
EIELSON AFB, AK 99702
(907) 377-4326
1821225913MR. ALTON E DOE JR. IDMT
Individual
Military Health Care Provider (Independent Duty Medical Technicians)2630 CENTRAL AVE STE 1
EIELSON AFB, AK 99702
(907) 377-4326
1710214382 STACEY R. SCHMITT LCSW
Individual
Social Worker (Clinical)2630 CENTRAL AVE MENTAL HEALTH CLINIC AND FAMILY ADVOCACY PROGRAM
EIELSON AFB, AK 99702
(907) 377-4041
1578545109DR. ROBERT GREG PATTERSON M.D.
Individual
Family Medicine2630 CENTRAL AVE SUITE 1M07
EIELSON AFB, AK 99702
(907) 377-1847
1255404752DR. RENEE LORAINE HORNSBY PHARM.D
Individual
Pharmacist2630 CENTRAL AVE SUITE 200
EIELSON AFB, AK 99702
(907) 377-1462
1154703155DR. MATTHEW GRAY CORBIN DDS
Individual
Dentist2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6767
1063612299DR. LARRY KROLL PH.D.
Individual
Psychologist (Clinical)2630 CENTRAL AVE 354 MDOS/SGOH
EIELSON AFB, AK 99702
(907) 377-3071
1104393446 MATTHEW GRAY IDMT
Individual
Military Health Care Provider (Independent Duty Medical Technicians)2630 CENTRAL AVE
EIELSON AFB, AK 99702
(931) 220-2210
1699193318 AMY ELIZABETH VAGEDES
Individual
Pediatrics2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6455
1639724636 SANDRA MUNIZ LPN
Individual
Licensed Practical Nurse2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6526
1912546524 SUSAN LIEBIG RDH
Individual
Dental Hygienist2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6767
1578189387 ERIC DYLAN MASON IDMT
Individual
Military Health Care Provider (Independent Duty Medical Technicians)2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6610
1689274664 BRADLEY MARTIN
Individual
Dental Hygienist2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6670
1891395802 KALEB HATFIELD
Individual
Dental Hygienist2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6767
1346840329 STEPHANIE DANIELLE ROWE
Individual
Dental Assistant2630 CENTRAL AVE
EIELSON AFB, AK 99702
(907) 377-6767

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902867229, enumerated in the NPI registry as an "organization" on March 28, 2006

The provider is located at 2630 Central Ave Suite 1m07 Eielson Afb, Ak 99702 and the phone number is (907) 377-6579

This medical organization specializes in Clinic/Center with taxonomy code 261QM1100X with a focus in Military/U.S. Coast Guard Outpatient

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on March 28, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.