NPIMap

Organization Active NPI

Carl Vinson Vamc

  • VA Clinic/Center
  • Dublin, GA
National Provider Identifier
1104936939
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
License
RN069362 Issued in GA
Legal business name
CARL VINSON VAMC
Practice address
1826 Veterans Blvd
Dublin, GA 31021-3620
Phone
(478) 272-1210
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Susan Beacham, RN
Title
Nurse Manager, Primary Care
Phone
(478) 272-1210

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X RN069362 GA Primary

Addresses

Primary practice location

1826 Veterans Blvd
Dublin, GA 31021-3620

Mailing address

1250 Achord Rd
Dublin, GA 31021-0715
Phone (478) 275-9681

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
11D0987704Carl Vinson Vamc1826 Veterans Blvd BLDG #3a, Dublin, GA 31021AccreditationMay 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
James a Haley Veterans' Hospital179 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 4

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1104936939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 ACHORD RD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310210715",
            "telephone_number": "478-275-9681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1826 VETERANS BLVD",
            "city": "DUBLIN",
            "state": "GA",
            "postal_code": "310213620",
            "telephone_number": "478-272-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARL VINSON VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BEACHAM",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "NURSE MANAGER, PRIMARY CARE",
        "authorized_official_telephone_number": "478-272-1210",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "GA",
            "license": "RN069362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.