NPIMap

Organization Active NPI

Memphis Vamc

  • VA Clinic/Center
  • Tupelo, MS
National Provider Identifier
1073552436
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
MEMPHIS VAMC
Practice address
1114 Commonwealth Blvd.
Tupelo, MS 38804-9998
Phone
(615) 355-3451
NPI assigned
Jun 4, 2006
Last updated
Sep 13, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Erin Potter
Title
Npi Team Member
Phone
(202) 382-2579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X NU Primary

Addresses

Primary practice location

1114 Commonwealth Blvd.
Tupelo, MS 38804-9998

Mailing address

PO Box 94511
Cleveland, OH 44101
Phone (615) 355-3451

Other names 1

  • TUPELO VA CBOC Other name

National Provider Directory

National Provider Directory
Tax ID family
Memphis Vamc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Locations

1114 Commonwealth Blvd
Tupelo, MS 38804
Phone (662) 840-6366

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505260800000",
    "number": "1073552436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94511",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "44101",
            "telephone_number": "615-355-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 COMMONWEALTH BLVD.",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388049998",
            "telephone_number": "615-355-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2017-09-13",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "NPI TEAM MEMBER",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TUPELO VA CBOC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.