201102 DMIS ID Table Change Report
Army
Authorized Branch of
Facility Facility Facility Facility 5- Facility 4- Health US Service Facility TRICARE Service/
DMIS MEPRS Unit Service Facility Country State Digit ZIP Digit ZIP Service Flag DMIS MEPRS Area Command Enrollment DHP Authority NPI 2 NPI 2 HIPAA
ID DCW ID ID Code Type Code DMIS Facility Name Facility Name Installation Name Code Code Facility City Name Code Code Region Code Parent ID Parent ID Code Code Site (Y/N) Code Code Required NPI 2 Number Taxonomy
TO 2001 A HOSP AUGUSTA VET ADMIN MED CTR AUGUSTA VETERANS ADMIN MEDICAL CENTER AUGUSTA VETERANS ADMIN MEDICAL CTR US GA AUGUSTA 30912 18 Y 0047 0047 SRMC N N *1 *N
FROM 2001 A HOSP AUGUSTA VET ADMIN MED CTR AUGUSTA VETERANS ADMIN MEDICAL CENTER AUGUSTA VETERANS ADMIN MEDICAL CTR US GA AUGUSTA 30912 18 Y 0047 0047 SRMC N N *B *
TO 2003 A HOSP LEAVENWORTH VA MEDICAL CENTER LEAVENWORTH VA MEDICAL CENTER LEAVENWORTH VA MEDICAL CENTER US KS LEAVENWORTH 66048 19 Y 0058 0058 WRMC N N *1 N
FROM 2003 A HOSP LEAVENWORTH VA MEDICAL CENTER LEAVENWORTH VA MEDICAL CENTER LEAVENWORTH VA MEDICAL CENTER US KS LEAVENWORTH 66048 19 Y 0058 0058 WRMC N N *B N
TO 2004 A HOSP CARL VINSON VA MEDICAL CENTER CARL VINSON VA MEDICAL CENTER CARL VINSON VA MEDICAL CENTER US GA DUBLIN 31021 18 Y 0047 0047 SRMC N N *1 *N
FROM 2004 A HOSP CARL VINSON VA MEDICAL CENTER CARL VINSON VA MEDICAL CENTER CARL VINSON VA MEDICAL CENTER US GA DUBLIN 31021 18 Y 0047 0047 SRMC N N *B *
TO 6105 A CLINIC *FAYETTEVILLE CLIN MEDICAL HOME *FAYETTEVILLE CLINIC MEDICAL HOME FT. BRAGG US NC FAYETTEVILLE 28304 17 Y 0089 0089 NRMC Y Y A Y 1760795769 261QM1100X
FROM 6105 A CLINIC *CBPCC 1-FT. BRAGG *COMMUNITY BASED PRIMARY CC 1-FT. BRAGG FT. BRAGG US NC FAYETTEVILLE 28304 17 Y 0089 0089 NRMC Y Y A Y 1760795769 261QM1100X
TO 6106 A CLINIC *HOPE MILLS CLINIC MEDICAL HOME *HOPE MILLS CLINIC MEDICAL HOME FT. BRAGG US NC HOPE MILLS 28348 17 Y 0089 0089 NRMC Y Y A Y 1134433402 261QM1100X
FROM 6106 A CLINIC *CBPCC 2-FT. BRAGG *COMMUNITY BASED PRIMARY CC 2-FT. BRAGG FT. BRAGG US NC HOPE MILLS 28348 17 Y 0089 0089 NRMC Y Y A Y 1134433402 261QM1100X
TO 6108 A CLINIC *SCREAMING EAGLE MEDICAL HOME *SCREAMING EAGLE MEDICAL HOME FT. CAMPBELL US TN CLARKSVILLE 37040 5349 17 Y 0060 0060 SRMC Y Y A Y 1275846263 261QM1100X
FROM 6108 A CLINIC *CBPCC 1-FT. CAMPBELL *COMMUNITY BASED PRIMARY CC 1-FT. CAMPBELL FT. CAMPBELL US TN CLARKSVILLE 37040 5349 17 Y 0060 0060 SRMC Y Y A Y 1275846263 261QM1100X
TO 6114 A CLINIC *MONCRIEF MEDICAL HOME *MONCRIEF MEDICAL HOME FT. JACKSON US SC COLUMBIA 29223 18 Y 0105 0105 SRMC Y Y A Y 1972823722 261QM1100X
FROM 6114 A CLINIC *CBPCC 1-FT. JACKSON *COMMUNITY BASED PRIMARY CC 1-FT. JACKSON FT. JACKSON US SC COLUMBIA 29223 18 Y 0105 0105 SRMC Y Y A Y 1972823722 261QM1100X
TO 6115 A CLINIC *LEONARD WOOD MEDICAL HOME *LEONARD WOOD MEDICAL HOME FT. LEONARD WOOD US MO SAINT ROBERT 65584 19 Y 0075 0075 WRMC Y Y A Y 1942529961 261QM1100X
FROM 6115 A CLINIC *CBPCC 1-FT. LEONARD WOOD *COMMUNITY BASED PRIMARY CC 1-FT. L WOOD FT. LEONARD WOOD US MO SAINT ROBERT 65584 19 Y 0075 0075 WRMC Y Y A Y 1942529961 261QM1100X
TO 6116 A CLINIC *MADIGAN-PUYALLUP MEDICAL HOME *MADIGAN-PUYALLUP MEDICAL HOME JOINT BASE LEWIS-MCCHORD US WA PUYALLUP 98375 19 Y 125 125 WRMC Y Y A Y 1851605356 261QM1100X
FROM 6116 A CLINIC *CBPCC 1-FT. LEWIS *COMMUNITY BASED PRIMARY CC 1-FT. LEWIS JOINT BASE LEWIS-MCCHORD US WA PUYALLUP 98375 19 Y 125 125 WRMC Y Y A Y 1851605356 261QM1100X
TO 6117 A CLINIC *MADIGAN-LACEY MEDICAL HOME *MADIGAN-LACEY MEDICAL HOME JOINT BASE LEWIS-MCCHORD US WA LACEY 98503 19 Y 125 125 WRMC Y Y A Y 1881907822 261QM1100X
FROM 6117 A CLINIC *CBPCC 2-FT. LEWIS *COMMUNITY BASED PRIMARY CC 2-FT. LEWIS JOINT BASE LEWIS-MCCHORD US WA LACEY 98503 19 Y 125 125 WRMC Y Y A Y 1881907822 261QM1100X
TO 6119 A CLINIC *SCHERTZ MEDICAL HOME *SCHERTZ MEDICAL HOME FT. SAM HOUSTON US TX SCHERTZ 78154 6200 18 Y 0109 0109 SRMC Y Y A Y 1265745293 261QM1100X
FROM 6119 A CLINIC *CBPCC 1-FT. SAM HOUSTON *COMMUNITY BASED PRMARY CC 1-FT SAM HOUSTON FT. SAM HOUSTON US TX SCHERTZ 78154 6200 18 Y 0109 0109 SRMC Y Y A Y 1265745293 261QM1100X
TO 6121 A CLINIC *FRONTIER MEDICAL HOME *FRONTIER MEDICAL HOME FT. SILL US OK LAWTON 73505 18 Y 0098 0098 SRMC Y Y A Y 1821318668 261QM1100X
FROM 6121 A CLINIC *CBPCC 1-FT. SILL *COMMUNITY BASED PRIMARY CC 1-FT. SILL FT. SILL US OK LAWTON 73505 18 Y 0098 0098 SRMC Y Y A Y 1821318668 261QM1100X
TO 6122 A CLINIC *RICHMOND HILL MEDICAL HOME *RICHMOND HILL MEDICAL HOME FT. STEWART US GA RICHMOND HILL 31324 18 Y 0049 0049 SRMC Y Y A Y 1235442328 261QM1100X
FROM 6122 A CLINIC *CBPCC 1-FT. STEWART *COMMUNITY BASED PRIMARY CC 1-FT. STEWART FT. STEWART US GA RICHMOND HILL 31324 18 Y 0049 0049 SRMC Y Y A Y 1235442328 261QM1100X
TO 7402 A ADMIN *21ST TSC *21ST TSC *WARNER BARRACKS GM *SCHWEINFURT *09139 13 N 7402 N N D
FROM 7402 A ADMIN *1 AD *1 AD *WIESBADEN ARMY AIR FIELD GM *WIESBADEN *09096 13 N 7402 N N D
TO 7403 A ADMIN *7TH JMTC *7TH JMTC *HOHENFELS GM *HOHENFELS *09173 13 N 7403 N N D
FROM 7403 A ADMIN *1 ID *1 ID *LEIGHTON BKS GM *WUERZBURG *09244 13 N 7403 N N D
TO 7404 *WAT6AA A *CLINIC *V CORPS STB (TOE) *V CORPS STB (TOE) *CAMPBELL BARRACKS *GM *HEIDELBERG *09103 13 N *7401 N N D
FROM 7404 * A *ADMIN *SETAF *SETAF *EDERLE BKS *IT *VICENZA *09630 13 N *7404 N N D
TO 7405 *WAPBAA A *CLINIC *1AD STB (TOE) *1AD STB (TOE) *WIESBADEN ARMY AIR FIELD GM *WIESBADEN *09096 13 N *7401 N N D
FROM 7405 * A *ADMIN *7 ATC *7 ATC *HOHENFELS CMTC GM *HOHENFELS *09173 13 N *7405 N N D
TO 7406 *WE35AA A CLINIC *2ND SCR CAS (TOE) *2ND SCR CAS (TOE) *ROSE BARRACKS GM *VILSECK *09112 13 N *7401 N N D
FROM 7406 *WH28AA A CLINIC *1 AD DIVARTY CAS (TOE) *1 AD DIVARTY CAS (TOE) *SMITH BKS GM *BAUMHOLDER *09340 13 N *7402 N N D
TO 7407 *WH98AA A CLINIC *170TH IBCTH (TOE) *170TH IBCTH (TOE) *SMITH BARRACKS GM *BAUMHOLDER *09034 13 N *7401 N N D
FROM 7407 *WAETAA A CLINIC *1/1CAV (TOE) *1/1CAV (TOE) *HC GM *BUEDINGEN *09076 13 N *7402 N N D
TO 7408 *WJTPCO A CLINIC *172ND IN (TOE) *172ND IN (TOE) *CONN BARRACKS GM *SCHWEINFURT *09033 13 N *7401 N N D
FROM 7408 *WAPYAA A CLINIC *1/35 AR (TOE) *1/35 AR (TOE) *SMITH BKS GM *BAUMHOLDER *09340 13 N *7402 N N D
TO 7409 *WARPAA A CLINIC *173RD ABCT (TOE) *173RD ABCT (TOE) *EDERLE BARRACKS *IT *VICENZA *09630 13 N *7401 N N D
FROM 7409 *WAPSAA A CLINIC *1/6 IN (TOE) *1/6 IN (TOE) *SMITH BKS *GM *BAUMHOLDER *09340 13 N *7402 N N D
TO 7410 *WCYPAA A CLINIC *12th CAB (TOE) *12TH CAB (TOE) *BARTON BARRACKS GM *ANSBACH *09177 13 N *7401 N N D
FROM 7410 *WDKXTO A CLINIC *1/94 FA (TOE) *1/94 FA (TOE) *STRASSBURG BKS GM *IDAR OBERSTEIN *09034 13 N *7402 N N D
TO 7411 *WHQCT0 A CLINIC *357TH AMD-D (TOE) *357TH AMDD (TOE) *RHINE ORDNANCE BARRACKS GM *KAISERSLAUTERN *09067 13 N *7401 N N D
FROM 7411 *WGM8AA A CLINIC *1-4 ADA (TOE) *1-4 ADA (TOE) *MCCULLY BKS GM *WACKERNHEIM *09185 13 N *7402 N N D
TO 7412 *WH7MAA A CLINIC *16TH SB BAS (TOE) *16TH SB BAS (TOE) *WARNER BARRACKS GM *SCHWEINFURT *09139 13 N 7402 N N D
FROM 7412 *WAEL99 A CLINIC *1st BDE CAS (TOE) *1st BDE CAS (TOE) *RAY BKS GM *FRIEDBERG *09074 13 N 7402 N N D
TO 7413 *WC7CAA A CLINIC *18TH EN (TOE) *18TH EN (TOE) *TOMPKINS BARRACKS GM *HEIDELBERG *09081 13 N 7402 N N D
FROM 7413 *WAEQAA A CLINIC *2/3 FA (TOE) *2/3 FA (TOE) *DEPOT BKS GM *GIESSEN *09045 13 N 7402 N N D
TO 7414 *WJCUTO A CLINIC *1/4TH IN REG (TOE) *1/4TH IN REG (TOE) *HOHENFELS GM *HOHENFELS *09173 13 N *7403 N N D
FROM 7414 *WAPWAA A CLINIC *2/6 IN (TOE) *2/6 IN (TOE) *SMITH BKS GM *BAUMHOLDER *09340 13 N *7402 N N D
Note: Asterisks indicate cells that were changed. Records for new DMIS IDs are listed at the end of this report. 1
12/14/2011
201102 DMIS ID Table Change Report
Navy
Authorized Branch of
Facility Facility Facility Facility 5- Facility 4- Health US Facility TRICARE Service/
Service Facility Country State Digit ZIP Digit ZIP Service Flag DMIS MEPRS Service Command Enrollment DHP Authority NPI 2 NPI 2 HIPAA
DMIS ID DCW ID MEPRS Unit ID Code Type Code DMIS Facility Name Facility Name Installation Name Code Code Facility City Name Code Code Region Code Parent ID Parent ID Area 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
12/14/2011
201102 DMIS ID Table Change Report
Air Force
Authorized Branch of
Facility Facility Facility Facility 5- Facility 4- Health US Facility TRICARE Service/
MEPRS Service Facility Country State Digit ZIP Digit ZIP Service Flag DMIS MEPRS Service 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 Parent ID Parent ID Area Code Code Site (Y/N) Code Code Required NPI 2 Number Taxonomy
TO 0832 0257 F *INACT 3rd ATH-ELMENDORF 3rd ATH ELMENDORF US AK ANCHORAGE 99506 19 Y 0006 PACAF N Y *I
FROM 0832 0257 F *CLINIC 3rd ATH-ELMENDORF 3rd ATH ELMENDORF US AK ANCHORAGE 99506 19 Y 0006 PACAF N Y *F
TO 0839 4556 F *INACT 20th ATH-SHAW AFB 20th ATH SHAW AFB US SC SUMTER 29152 18 Y 0839 ACC N Y *I
FROM 0839 4556 F *CLINIC 20th ATH-SHAW AFB 20th ATH SHAW AFB US SC SUMTER 29152 18 Y 0839 ACC N Y *F
TO 0841 KS64 F *INACT 51st ATH-OSAN AB 51st ATH OSAN AB KS SONG TAN 96278 14 N 0841 PACAF N Y *I
FROM 0841 KS64 F *CLINIC 51st ATH-OSAN AB 51st ATH OSAN AB KS SONG TAN 96278 14 N 0841 PACAF N Y *F
TO 1262 1267 F *INACT 55th ATH-OFFUTT 55th AIR TRANSPORTABLE HOSPITAL OFFUTT AFB US NE OMAHA 68113 19 Y 0078 ACC N Y *I
FROM 1262 1267 F *CLINIC 55th ATH-OFFUTT 55th AIR TRANSPORTABLE HOSPITAL OFFUTT AFB US NE OMAHA 68113 19 Y 0078 ACC N Y *F
TO 1263 3754 F *INACT 4th ATH-SEYMOUR JOHNSON 4th AIR TRANSPORTABLE HOSPITAL SEYMOUR JOHNSON AFB US NC GOLDSBORO 27531 17 Y 0090 ACC N Y *I
FROM 1263 3754 F *CLINIC 4th ATH-SEYMOUR JOHNSON 4th AIR TRANSPORTABLE HOSPITAL SEYMOUR JOHNSON AFB US NC GOLDSBORO 27531 17 Y 0090 ACC N Y *F
TO 7056 5152 F *INACT 633rd ATH-JB LANGLEY-EUSTIS 633rd AIR TRANSPORTABLE HOSPITAL JOINT BASE LANGLEY-EUSTIS US VA HAMPTON 23665 17 Y 0120 ACC N Y *I
FROM 7056 5152 F *CLINIC 633rd ATH-JB LANGLEY-EUSTIS 633rd AIR TRANSPORTABLE HOSPITAL JOINT BASE LANGLEY-EUSTIS US VA HAMPTON 23665 17 Y 0120 ACC N Y *F
TO 7057 1265 FF8T60 F *INACT 6th ATH-MACDILL 6th AIR TRANSPORTABLE HOSPITAL MACDILL AFB US FL TAMPA 33621 18 Y 0045 AMC N Y *I
FROM 7057 1265 FF8T60 F *CLINIC 6th ATH-MACDILL 6th AIR TRANSPORTABLE HOSPITAL MACDILL AFB US FL TAMPA 33621 18 Y 0045 AMC N Y *F
TO 7058 456 F *INACT 59th ATH-WILFORD HALL 59TH AIR TRANSPORTABLE HOSPITAL LACKLAND AFB US TX SAN ANTONIO 78236 18 Y 0117 AETC N Y *I
FROM 7058 456 F *CLINIC 59th ATH-WILFORD HALL 59TH AIR TRANSPORTABLE HOSPITAL LACKLAND AFB US TX SAN ANTONIO 78236 18 Y 0117 AETC N Y *F
TO 7060 3557 F *INACT 49th ATH-HOLLOMAN 49th AIR TRANSPORTABLE HOSPITAL HOLLOMAN AFB US NM ALAMOGORDO 88330 19 Y 0084 ACC N Y *I
FROM 7060 3557 F *CLINIC 49th ATH-HOLLOMAN 49th AIR TRANSPORTABLE HOSPITAL HOLLOMAN AFB US NM ALAMOGORDO 88330 19 Y 0084 ACC N Y *F
TO 7062 457 F *INACT 58TH AIR TRANS HOSP (ATH) 58TH AIR TRANSPORTABLE HOSPITAL LUKE AFB US AZ PHOENIX 85309 19 Y 0009 AETC N Y *I
FROM 7062 457 F *CLINIC 58TH AIR TRANS HOSP (ATH) 58TH AIR TRANSPORTABLE HOSPITAL LUKE AFB US AZ PHOENIX 85309 19 Y 0009 AETC N Y *F
TO 7103 F *INACT 99th ATH-NELLIS 99th AIR TRANSPORTABLE HOSPITAL NELLIS AFB US NV LAS VEGAS 89191 19 Y 7103 ACC N Y *I
FROM 7103 F *CLINIC 99th ATH-NELLIS 99th AIR TRANSPORTABLE HOSPITAL NELLIS AFB US NV LAS VEGAS 89191 19 Y 7103 ACC N Y *F
TO 7104 F *INACT 366th ATH-MOUNTAIN HOME 366th AIR TRANSPORTABLE HOSPITAL MOUNTAIN HOME AFB US ID MOUNTAIN HOME 83648 19 Y 7104 ACC N Y *I
FROM 7104 F *CLINIC 366th ATH-MOUNTAIN HOME 366th AIR TRANSPORTABLE HOSPITAL MOUNTAIN HOME AFB US ID MOUNTAIN HOME 83648 19 Y 7104 ACC N Y *F
TO 7105 F *INACT 39th ATH-INCIRLIK 39th AIR TRANSPORTABLE HOSPITAL INCIRLIK AB TU INCIRLIK 09824 13 N 7105 USAFE N Y *I
FROM 7105 F *CLINIC 39th ATH-INCIRLIK 39th AIR TRANSPORTABLE HOSPITAL INCIRLIK AB TU INCIRLIK 09824 13 N 7105 USAFE N Y *F
Note: Asterisks indicate cells that were changed. Records for new DMIS IDs are listed at the end of this report. 3
12/14/2011
201102 DMIS ID Table Change Report
Other
Authorized Branch of
Facility Facility Facility Facility 5- Facility 4- Health US DMIS MEPRS Service Facility TRICARE Service/
DMIS DCW MEPRS Service Facility Type Country State Digit ZIP Digit 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 6901 M *INACT MANAGED CARE CNTRCTR-REGION 01 MANAGED CARE CONTRACTOR-REGION 01 REGION 01 US 01 Y Y Y *I
FROM 6901 M *TSCPCM MANAGED CARE CNTRCTR-REGION 01 MANAGED CARE CONTRACTOR-REGION 01 REGION 01 US 01 Y Y Y *M
TO 6902 M *INACT MANAGED CARE CNTRCTR-REGION 02 MANAGED CARE CONTRACTOR-REGION 02 REGION 02 US 02 Y Y Y *I
FROM 6902 M *TSCPCM MANAGED CARE CNTRCTR-REGION 02 MANAGED CARE CONTRACTOR-REGION 02 REGION 02 US 02 Y Y Y *M
TO 6903 M *INACT MANAGED CARE CNTRCTR-REGION 03 MANAGED CARE CONTRACTOR-REGION 03 REGION 03 US 03 Y Y Y *I
FROM 6903 M *TSCPCM MANAGED CARE CNTRCTR-REGION 03 MANAGED CARE CONTRACTOR-REGION 03 REGION 03 US 03 Y Y Y *M
TO 6904 M *INACT MANAGED CARE CNTRCTR-REGION 04 MANAGED CARE CONTRACTOR-REGION 04 REGION 04 US 04 Y Y Y *I
FROM 6904 M *TSCPCM MANAGED CARE CNTRCTR-REGION 04 MANAGED CARE CONTRACTOR-REGION 04 REGION 04 US 04 Y Y Y *M
TO 6905 M *INACT MANAGED CARE CNTRCTR-REGION 05 MANAGED CARE CONTRACTOR-REGION 05 REGION 05 US 05 Y Y Y *I
FROM 6905 M *TSCPCM MANAGED CARE CNTRCTR-REGION 05 MANAGED CARE CONTRACTOR-REGION 05 REGION 05 US 05 Y Y Y *M
TO 6906 M *INACT MANAGED CARE CNTRCTR-REGION 06 MANAGED CARE CONTRACTOR-REGION 06 REGION 06 US 06 Y Y Y *I
FROM 6906 M *TSCPCM MANAGED CARE CNTRCTR-REGION 06 MANAGED CARE CONTRACTOR-REGION 06 REGION 06 US 06 Y Y Y *M
TO 6907 M *INACT MANAGED CARE CNTRCTR-REGION 07 MANAGED CARE CONTRACTOR-REGION 07 REGION 07 US 07 Y Y Y *I
FROM 6907 M *TSCPCM MANAGED CARE CNTRCTR-REGION 07 MANAGED CARE CONTRACTOR-REGION 07 REGION 07 US 07 Y Y Y *M
TO 6908 M *INACT MANAGED CARE CNTRCTR-REGION 08 MANAGED CARE CONTRACTOR-REGION 08 REGION 08 US 08 Y Y Y *I
FROM 6908 M *TSCPCM MANAGED CARE CNTRCTR-REGION 08 MANAGED CARE CONTRACTOR-REGION 08 REGION 08 US 08 Y Y Y *M
TO 6909 M *INACT MANAGED CARE CNTRCTR-REGION 09 MANAGED CARE CONTRACTOR-REGION 09 REGION 09 US 09 Y Y Y *I
FROM 6909 M *TSCPCM MANAGED CARE CNTRCTR-REGION 09 MANAGED CARE CONTRACTOR-REGION 09 REGION 09 US 09 Y Y Y *M
TO 6910 M *INACT MANAGED CARE CNTRCTR-REGION 10 MANAGED CARE CONTRACTOR-REGION 10 REGION 10 US 10 Y Y Y *I
FROM 6910 M *TSCPCM MANAGED CARE CNTRCTR-REGION 10 MANAGED CARE CONTRACTOR-REGION 10 REGION 10 US 10 Y Y Y *M
TO 6911 M *INACT MANAGED CARE CNTRCTR-REGION 11 MANAGED CARE CONTRACTOR-REGION 11 REGION 11 US 11 Y Y Y *I
FROM 6911 M *TSCPCM MANAGED CARE CNTRCTR-REGION 11 MANAGED CARE CONTRACTOR-REGION 11 REGION 11 US 11 Y Y Y *M
TO 6912 M *INACT MANAGED CARE CNTRCTR-REGION 12 MANAGED CARE CONTRACTOR-REGION 12 REGION 12 US 12 Y Y Y *I
FROM 6912 M *TSCPCM MANAGED CARE CNTRCTR-REGION 12 MANAGED CARE CONTRACTOR-REGION 12 REGION 12 US 12 Y Y Y *M
TO 8001 M *INACT 88TH MED GROUP-TSC PCM 88TH MED GROUP-WRIGHT PATTERSON TSC PCM WRIGHT-PATTERSON AFB US OH WRIGHT-PATTERSON 45433 5300 17 Y 6905 N N *I
FROM 8001 M *TSCPCM 88TH MED GROUP-TSC PCM 88TH MED GROUP-WRIGHT PATTERSON TSC PCM WRIGHT-PATTERSON AFB US OH WRIGHT-PATTERSON 45433 5300 17 Y 6905 N N *M
TO 8002 M *INACT SCOTT MED CENTER TSC-PCM SCOTT MEDICAL CENTER TSC-PCM SCOTT AFB US IL SCOTT AFB 62225 5300 17 Y 6905 N N *I
FROM 8002 M *TSCPCM SCOTT MED CENTER TSC-PCM SCOTT MEDICAL CENTER TSC-PCM SCOTT AFB US IL SCOTT AFB 62225 5300 17 Y 6905 N N *M
TO 8003 M *INACT NAV HOSP GREAT LAKES TSC-PCM NAVAL HOSPITAL GREAT LAKES TSC-PCM GREAT LAKES NAVAL BASE US IL GREAT LAKES NAVAL BASE 60088 5000 17 Y 6905 N N *I
FROM 8003 M *TSCPCM NAV HOSP GREAT LAKES TSC-PCM NAVAL HOSPITAL GREAT LAKES TSC-PCM GREAT LAKES NAVAL BASE US IL GREAT LAKES NAVAL BASE 60088 5000 17 Y 6905 N N *M
TO 8004 M *INACT BLANCHFIELD ARMY HOSP TSC-PCM BLANCHFIELD ARMY HOSPITAL TSC-PCM FORT CAMPBELL US KY FORT CAMPBELL 42223 5349 17 Y 6905 N N *I
FROM 8004 M *TSCPCM BLANCHFIELD ARMY HOSP TSC-PCM BLANCHFIELD ARMY HOSPITAL TSC-PCM FORT CAMPBELL US KY FORT CAMPBELL 42223 5349 17 Y 6905 N N *M
TO 8005 M *INACT IRELAND ACH-KNOX TSC-PCM IRELAND ARMY COMMUNITY HOSPITAL TSC-PCM FORT KNOX US KY FORT KNOX 17 Y 6905 N N *I
FROM 8005 M *TSCPCM IRELAND ACH-KNOX TSC-PCM IRELAND ARMY COMMUNITY HOSPITAL TSC-PCM FORT KNOX US KY FORT KNOX 17 Y 6905 N N *M
TO 8006 M *INACT PORTSMOUTH VA-MCS-PCM PORTSMOUTH VA-MCS CONTRACTOR PCM PORTSMOUTH VA US VA 17 Y 6902 N N *I
FROM 8006 M *TSCPCM PORTSMOUTH VA-MCS-PCM PORTSMOUTH VA-MCS CONTRACTOR PCM PORTSMOUTH VA US VA 17 Y 6902 N N *M
TO 8007 M *INACT CAMP LEJEUNE-MCS-PCM CAMP LEJUENE MCS CONTRACTOR PCM CAMP LEJEUNE US NC CAMP LEJUENE 28547 17 Y 6902 N N *I
FROM 8007 M *TSCPCM CAMP LEJEUNE-MCS-PCM CAMP LEJUENE MCS CONTRACTOR PCM CAMP LEJEUNE US NC CAMP LEJUENE 28547 17 Y 6902 N N *M
TO 8008 M *INACT SEYMOUR JOHNSON AFB-MCS-PCM SEYMOUR JOHNSON AFB MCS CONTRACTOR PCM SEYMOUR JOHNSON AFB US NC 17 Y 6902 N N *I
FROM 8008 M *TSCPCM SEYMOUR JOHNSON AFB-MCS-PCM SEYMOUR JOHNSON AFB MCS CONTRACTOR PCM SEYMOUR JOHNSON AFB US NC 17 Y 6902 N N *M
TO 8009 M *INACT FT BRAGG-MCS-PCM FT BRAGG MCS CONTRACTOR PCM FORT BRAGG US NC FORT BRAGG 28310 17 Y 6902 N N *I
FROM 8009 M *TSCPCM FT BRAGG-MCS-PCM FT BRAGG MCS CONTRACTOR PCM FORT BRAGG US NC FORT BRAGG 28310 17 Y 6902 N N *M
TO 8010 M *INACT 779TH MED GRP ANDREWS TSC-PCM 779TH MEDICAL GROUP TSC-PCM JOINT BASE ANDREWS NAVAL AIR FAC US MD ANDREWS AFB 20762 17 Y 6901 N N *I
FROM 8010 M *TSCPCM 779TH MED GRP ANDREWS TSC-PCM 779TH MEDICAL GROUP TSC-PCM JOINT BASE ANDREWS NAVAL AIR FAC US MD ANDREWS AFB 20762 17 Y 6901 N N *M
TO 8011 M *INACT 87TH MED GRP MCGUIRE TSC-PCM 87TH MEDICAL GROUP TSC-PCM JOINT BASE MCGUIRE-DIX-LAKEHURST US NJ MCGUIRE AFB 8641 17 Y 6901 N N *I
FROM 8011 M *TSCPCM 87TH MED GRP MCGUIRE TSC-PCM 87TH MEDICAL GROUP TSC-PCM JOINT BASE MCGUIRE-DIX-LAKEHURST US NJ MCGUIRE AFB 8641 17 Y 6901 N N *M
TO 8012 M *INACT 66TH MED GRP HANSCOM TSC-PCM 66TH MEDICAL GROUP TSC-PCM HANSCOM AFB US MA BOSTON 1731 17 Y 6901 N N *I
FROM 8012 M *TSCPCM 66TH MED GRP HANSCOM TSC-PCM 66TH MEDICAL GROUP TSC-PCM HANSCOM AFB US MA BOSTON 1731 17 Y 6901 N N *M
TO 8013 M *INACT 436TH MED GRP DOVER TSC-PCM 436TH MEDICAL GROUP TSC-PCM DOVER AFB US DE DOVER 17 Y 6901 N N *I
FROM 8013 M *TSCPCM 436TH MED GRP DOVER TSC-PCM 436TH MEDICAL GROUP TSC-PCM DOVER AFB US DE DOVER 17 Y 6901 N N *M
TO 8014 M *INACT WALTER REED AMC TSC-PCM WALTER REED ARMY MEDICAL CENTER TSC-PCM WASHINGTON D.C. US DC WASHINGTON 20307 17 Y 6901 N N *I
FROM 8014 M *TSCPCM WALTER REED AMC TSC-PCM WALTER REED ARMY MEDICAL CENTER TSC-PCM WASHINGTON D.C. US DC WASHINGTON 20307 17 Y 6901 N N *M
TO 8015 M *INACT KELLER ACH TSC-PCM KELLER ACH TSC-PCM WEST POINT US NY WEST POINT 10996 17 Y 6901 N N *I
FROM 8015 M *TSCPCM KELLER ACH TSC-PCM KELLER ACH TSC-PCM WEST POINT US NY WEST POINT 10996 17 Y 6901 N N *M
TO 8016 M *INACT GUTHRIE AHC-FT. DRUM TSC-PCM GUTHRIE AHC TSC-PCM FORT DRUM US NY FT. DRUM 13602 17 Y 6901 N N *I
FROM 8016 M *TSCPCM GUTHRIE AHC-FT. DRUM TSC-PCM GUTHRIE AHC TSC-PCM FORT DRUM US NY FT. DRUM 13602 17 Y 6901 N N *M
TO 8017 M *INACT NNMC BETHESDA TSC-PCM NNMC BETHESDA TSC-PCM BETHESDA US MD BETHESDA 20814 17 Y 6901 N N *I
FROM 8017 M *TSCPCM NNMC BETHESDA TSC-PCM NNMC BETHESDA TSC-PCM BETHESDA US MD BETHESDA 20814 17 Y 6901 N N *M
TO 8018 M *INACT NAVAMBCARECEN GROTON TSC-PCM NAVAL AMBULATORY CARE CENTER TSC-PCM GROTON US CT GROTON 17 Y 6901 N N *I
FROM 8018 M *TSCPCM NAVAMBCARECEN GROTON TSC-PCM NAVAL AMBULATORY CARE CENTER TSC-PCM GROTON US CT GROTON 17 Y 6901 N N *M
TO 8019 M *INACT CHANUTE AFB(RANTOUL) TSC-PCM CHANUTE AFB(RANTOUL) TSC-PCM US IL 17 Y 6905 N N *I
FROM 8019 M *TSCPCM CHANUTE AFB(RANTOUL) TSC-PCM CHANUTE AFB(RANTOUL) TSC-PCM US IL 17 Y 6905 N N *M
TO 8020 M *INACT FT BENJAMIN HARRISON TSC-PCM FT BENJAMIN HARRISON(INDIANAPOLIS) TSC-PCM US IN 17 Y 6905 N N *I
FROM 8020 M *TSCPCM FT BENJAMIN HARRISON TSC-PCM FT BENJAMIN HARRISON(INDIANAPOLIS) TSC-PCM US IN 17 Y 6905 N N *M
TO 8021 M *INACT GRISSOM AFB(PERU) TSC-PCM GRISSOM AFB(PERU) TSC-PCM US IN 17 Y 6905 N N *I
FROM 8021 M *TSCPCM GRISSOM AFB(PERU) TSC-PCM GRISSOM AFB(PERU) TSC-PCM US IN 17 Y 6905 N N *M
TO 8022 M *INACT KI SAWYER AFB(GWINN) TSC-PCM KI SAWYER AFB(GWINN) TSC-PCM US MI 17 Y 6905 N N *I
FROM 8022 M *TSCPCM KI SAWYER AFB(GWINN) TSC-PCM KI SAWYER AFB(GWINN) TSC-PCM US MI 17 Y 6905 N N *M
Note: Asterisks indicate cells that were changed. Records for new DMIS IDs are listed at the end of this report. 4
12/14/2011
201102 DMIS ID Table Change Report
Other
Authorized Branch of
Facility Facility Facility Facility 5- Facility 4- Health US DMIS MEPRS Service Facility TRICARE Service/
DMIS DCW MEPRS Service Facility Type Country State Digit ZIP Digit 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 8023 M *INACT WURTSMITH AFB(OSCODA) TSC-PCM WURTSMITH AFB(OSCODA) TSC-PCM US MI 17 Y 6905 N N *I
FROM 8023 M *TSCPCM WURTSMITH AFB(OSCODA) TSC-PCM WURTSMITH AFB(OSCODA) TSC-PCM US MI 17 Y 6905 N N *M
TO 8024 M *INACT AKRON/CANTON TSC-PCM AKRON/CANTON TSC-PCM US OH 17 Y 6905 N N *I
FROM 8024 M *TSCPCM AKRON/CANTON TSC-PCM AKRON/CANTON TSC-PCM US OH 17 Y 6905 N N *M
TO 8025 M *INACT CHICAGO/GARY TSC-PCM CHICAGO/GARY TSC-PCM US IL 17 Y 6905 N N *I
FROM 8025 M *TSCPCM CHICAGO/GARY TSC-PCM CHICAGO/GARY TSC-PCM US IL 17 Y 6905 N N *M
TO 8026 M *INACT CINCINNATI TSC-PCM CINCINNATI TSC-PCM US OH 17 Y 6905 N N *I
FROM 8026 M *TSCPCM CINCINNATI TSC-PCM CINCINNATI TSC-PCM US OH 17 Y 6905 N N *M
TO 8027 M *INACT CLEVELAND TSC-PCM CLEVELAND TSC-PCM US OH 17 Y 6905 N N *I
FROM 8027 M *TSCPCM CLEVELAND TSC-PCM CLEVELAND TSC-PCM US OH 17 Y 6905 N N *M
TO 8028 M *INACT COLUMBUS TSC-PCM COLUMBUS TSC-PCM US OH 17 Y 6905 N N *I
FROM 8028 M *TSCPCM COLUMBUS TSC-PCM COLUMBUS TSC-PCM US OH 17 Y 6905 N N *M
TO 8029 M *INACT DETROIT TSC-PCM DETROIT TSC-PCM US MI 17 Y 6905 N N *I
FROM 8029 M *TSCPCM DETROIT TSC-PCM DETROIT TSC-PCM US MI 17 Y 6905 N N *M
TO 8030 M INACT LANGLEY AFB TSC-PCM LANGLEY AFB TSC-PCM LANGLEY AFB US VA HAMPTON 17 Y 6902 N N *I
FROM 8030 M INACT LANGLEY AFB TSC-PCM LANGLEY AFB TSC-PCM LANGLEY AFB US VA HAMPTON 17 Y 6902 N N *M
TO 8031 M *INACT NH CHERRY POINT TSC-PCM NH CHERRY POINT TSC-PCM NH CHERRY POINT US NC CHERRY POINT 17 Y 6902 N N *I
FROM 8031 M *TSCPCM NH CHERRY POINT TSC-PCM NH CHERRY POINT TSC-PCM NH CHERRY POINT US NC CHERRY POINT 17 Y 6902 N N *M
TO 8032 M INACT FORT LEE TSC-PCM FORT LEE TSC-PCM FORT LEE US VA FORT LEE 17 Y 6902 N N *I
FROM 8032 M INACT FORT LEE TSC-PCM FORT LEE TSC-PCM FORT LEE US VA FORT LEE 17 Y 6902 N N *M
TO 8033 M INACT FORT EUSTIS TSC-PCM FORT EUSTIS TSC-PCM FORT EUSTIS US VA FORT EUSTIS 17 Y 6902 N N *I
FROM 8033 M INACT FORT EUSTIS TSC-PCM FORT EUSTIS TSC-PCM FORT EUSTIS US VA FORT EUSTIS 17 Y 6902 N N *M
TO 8034 M *INACT MILWAUKEE TSC-PCM MILWAUKEE TSC-PCM US WI 17 Y 6905 N N *I
FROM 8034 M *TSCPCM MILWAUKEE TSC-PCM MILWAUKEE TSC-PCM US WI 17 Y 6905 N N *M
TO 8035 M *INACT ST LOUIS TSC-PCM ST LOUIS TSC-PCM US MO 17 Y 6905 N N *I
FROM 8035 M *TSCPCM ST LOUIS TSC-PCM ST LOUIS TSC-PCM US MO 17 Y 6905 N N *M
TO 8036 M *INACT YOUNGSTOWN TSC-PCM YOUNGSTOWN TSC-PCM US OH 17 Y 6905 N N *I
FROM 8036 M *TSCPCM YOUNGSTOWN TSC-PCM YOUNGSTOWN TSC-PCM US OH 17 Y 6905 N N *M
Note: Asterisks indicate cells that were changed. Records for new DMIS IDs are listed at the end of this report. 5
12/14/2011