NPIMap

Organization Active NPI

Montrose Vamc

  • VA Clinic/Center
  • Port Jervis, NY
National Provider Identifier
1104863760
Registry record updated Jan 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
MONTROSE VAMC
Practice address
100 Pike St
Port Jervis, NY 12771-1831
Phone
(717) 277-6565
NPI assigned
Jun 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2023

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 Primary

Addresses

Primary practice location

100 Pike St
Port Jervis, NY 12771-1831

Mailing address

PO Box 94442
Cleveland, OH 44101-4442
Phone (717) 277-6565

Other names 1

  • PORT JERVIS VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Montrose Vamc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

150 Pike St
Port Jervis, NY 12771
Phone (845) 856-5396

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1104863760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94442",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014442",
            "telephone_number": "717-277-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PIKE ST",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127711831",
            "telephone_number": "717-277-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTROSE VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "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": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PORT JERVIS VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Jervis, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; 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.