200810 DMIS ID Table Change Report
Army
Facility Facility Authorized Branch of
Facility Facility Facility 5-Digit 4-Digit Health US DMIS MEPRS Service Facility TRICARE Service/
DMIS DCW MEPRS Unit Service Facility Country State ZIP ZIP Service Flag Parent Parent Area Command Enrollment DHP Authority NPI 2 NPI 2 HIPAA
ID ID ID Code Type Code DMIS Facility Name Facility Name Installation Name Code Code Facility City Name Code Code Region Code ID ID Code Code Site (Y/N) Code Code Required NPI 2 Number Taxonomy
NEW 6077 W2M5AA A CLINIC TBI 1 CLINIC-FT. HOOD TBI 1 CLINIC-FT. HOOD FT. HOOD US TX FT. HOOD 76544 4752 18 Y 0110 0110 GPRMC N Y A Y
NEW 6099 W2NVAA A CLINIC CRAIG ROAD TMC #1-FT. SILL CRAIG ROAD TMC #1-FT. SILL FT. SILL US OK FT. SILL 73503 9042 18 Y 0098 0098 GPRMC N Y A Y
Note: Asterisks indicate cells that were changed. Records for new DMIS IDs are listed at the end of this report. 1
12/9/2011
200810 DMIS ID Table Change Report
Navy
Facility Facility Authorized Branch of
Facility Facility Facility 5-Digit 4-Digit Health US DMIS MEPRS Service Facility TRICARE Service/
MEPRS Service Facility Country State ZIP ZIP Service Flag Parent Parent Area Command Enrollment DHP Authority NPI 2 NPI 2 HIPAA
DMIS ID DCW ID Unit ID Code Type Code DMIS Facility Name Facility Name Installation Name Code Code Facility City Name Code Code Region Code ID ID Code Code Site (Y/N) Code Code Required NPI 2 Number Taxonomy
No changes
Note: Asterisks indicate cells that were changed. Records for new DMIS IDs are listed at the end of this report. 2
12/9/2011
200810 DMIS ID Table Change Report
Air Force
Facility Facility Authorized Branch of
Facility Facility Facility Facility 5-Digit 4-Digit Health US DMIS MEPRS Service Facility TRICARE Service/
DMIS DCW MEPRS Service Type Country State ZIP ZIP Service Flag Parent Parent Area Command Enrollment DHP Authority NPI 2 NPI 2 HIPAA
ID ID Unit ID Code Code DMIS Facility Name Facility Name Installation Name Code Code Facility City Name Code Code Region Code ID ID Code Code Site (Y/N) Code Code Required NPI 2 Number Taxonomy
TO 0013 0553 FFH730 F CLINIC *19th MEDICAL GROUP-LITTLE ROCK *19th MEDICAL GROUP-LITTLE ROCK LITTLE ROCK AFB US AR *LITTLE ROCK AIR FORCE BASE 72099 18 Y 0013 0013 *AMC Y Y F Y 1073591830 261QM1100X
FROM 0013 0553 FFH730 F CLINIC *314th MED GRP-LITTLE ROCK *314th MEDICAL GROUP LITTLE ROCK AFB US AR *LITTLE ROCK 72099 18 Y 0013 0013 *AETC Y Y F Y 1073591830 261QM1100X
TO 0033 0857 FFBCD0 F *CLINIC 10th MED GROUP-USAF ACADEMY CO 10TH MEDICAL GROUP USAF ACADEMY US CO *U S A F ACADEMY 80840 19 Y 0033 0033 6004 USAFA Y Y F Y 1780657239 2865M2000X
FROM 0033 0857 FFBCD0 F *HOSP 10th MED GROUP-USAF ACADEMY CO 10TH MEDICAL GROUP USAF ACADEMY US CO *COLORADO SPRINGS 80840 19 Y 0033 0033 6004 USAFA Y Y F Y 1780657239 2865M2000X
TO 0066 2451 FFCMW0 F HOSP *779th MED GRP-ANDREWS *779th MEDICAL GROUP ANDREWS AFB US MD ANDREWS AFB 20762 17 Y 0066 0066 6015 AFDW Y Y F Y 1215994660 2865M2000X
FROM 0066 2451 FFCMW0 F HOSP *79th MED GRP-ANDREWS *79th MEDICAL GROUP ANDREWS AFB US MD ANDREWS AFB 20762 17 Y 0066 0066 6015 AFDW Y Y F Y 1215994660 2865M2000X
TO 1787 F DENTAL *779TH DENTAL SQ/SGD-ANDREWS *779TH DENTAL SQ/SGD ANDREWS AFB US MD ANDREWS AFB 20762 17 Y 0066 0066 AFDW N Y F
FROM 1787 F DENTAL *79TH DENTAL SQ/SGD-ANDREWS *79TH DENTAL SQ/SGD ANDREWS AFB US MD ANDREWS AFB 20762 17 Y 0066 0066 AFDW N Y F
NEW 5463 F HOSP UC DAVIS MEDICAL CENTER (CIV) UC DAVIS MEDICAL CENTER (CIVILIAN) UC DAVIS MEDICAL CENTER (CIVILIAN) US CA SACRAMENTO 95817 2201 19 Y 0014 0014 AMC N N G Y 1710918545 282N00000X
NEW 5464 F HOSP BAPTIST HEALTH SYSTEM (CIV) BAPTIST HEALTH SYSTEM (CIVILIAN) BAPTIST HEALTH SYSTEM (CIVILIAN) US TX SAN ANTONIO 78205 1201 18 Y 0117 0117 AETC N N G Y 1598744856 282N00000X
Note: Asterisks indicate cells that were changed. Records for new DMIS IDs are listed at the end of this report. 3
12/9/2011
200810 DMIS ID Table Change Report
Other
Facility Facility Authorized Branch of
Facility Facility Facility 5-Digit 4-Digit Health US DMIS MEPRS Service Facility TRICARE Service/
DCW MEPRS Service Facility Country State ZIP ZIP Service Flag Parent Parent Area Command Enrollment DHP Authority NPI 2 NPI 2 HIPAA
DMIS ID ID Unit ID Code Type Code DMIS Facility Name Facility Name Installation Name Code Code Facility City Name Code Code Region Code ID ID Code Code Site (Y/N) Code Code Required NPI 2 Number Taxonomy
TO 8010 M TSCPCM *779TH MED GRP ANDREWS TSC-PCM *779TH MEDICAL GROUP TSC-PCM ANDREWS AFB US MD *ANDREWS AFB 20762 17 Y 6901 N N M
FROM 8010 M TSCPCM *79TH MED GRP ANDREWS TSC-PCM *79TH MEDICAL GROUP TSC-PCM ANDREWS AFB US MD *WASHINGTON D.C. 20762 17 Y 6901 N N M
Note: Asterisks indicate cells that were changed. Records for new DMIS IDs are listed at the end of this report. 4
12/9/2011