NPIMap

Organization Active NPI

St. Louis JC Vamc

  • VA Clinic/Center
  • Scott Air Force Base, IL
National Provider Identifier
1093192908
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
ST. LOUIS JC VAMC
Practice address
310 W Losey St
375TH Medical Group
Scott Air Force Base, IL 62225-5250
Phone
(913) 578-4409
NPI assigned
Apr 29, 2015
Last updated
May 7, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

310 W Losey St
375TH Medical Group
Scott Air Force Base, IL 62225-5250

Mailing address

PO Box 94462
Cleveland, OH 44101-4462
Phone (913) 578-4409

Other names 1

  • SCOTT AIR FORCE BASE VA CLINIC Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2326049Scott Air Force Base Outpatient Clinic310 W Losey St, Scott Air Force Base, IL 62225AccreditationMay 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
St Louis JC Vamc45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778112000000",
    "number": "1093192908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94462",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014462",
            "telephone_number": "913-578-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W LOSEY ST",
            "address_2": "375TH MEDICAL GROUP",
            "city": "SCOTT AIR FORCE BASE",
            "state": "IL",
            "postal_code": "622255250",
            "telephone_number": "913-578-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS JC VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "NPI TEAM",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCOTT AIR FORCE BASE VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Scott Air Force Base, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.