Provider Demographics
NPI:1255380697
Name:NAVAL MEDICAL CENTER PORTSMOUTH
Entity type:Organization
Organization Name:NAVAL MEDICAL CENTER PORTSMOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:UBO MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFFER-LANNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-953-5297
Mailing Address - Street 1:620 JOHN PAUL JONES CIRCLE
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23708-2197
Mailing Address - Country:US
Mailing Address - Phone:757-953-5297
Mailing Address - Fax:
Practice Address - Street 1:620 JOHN PAUL JONES CIRCLE
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23708-2197
Practice Address - Country:US
Practice Address - Phone:757-953-5297
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NAVAL MEDICAL CENTER PORTSMOUTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-10
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2865M2000XHospitalsMilitary HospitalMilitary General Acute Care Hospital
No261QM1101XAmbulatory Health Care FacilitiesClinic/CenterMilitary and U.S. Coast Guard Ambulatory Procedure