NPIMap

Organization Active NPI

Iron Mountain Vamc

  • VA Clinic/Center
  • Manistique, MI
National Provider Identifier
1114334174
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
IRON MOUNTAIN VAMC
Practice address
813 East Lakeshore Drive
Manistique, MI 49854-1683
Phone
(608) 821-7200
Fax
(608) 821-7658
NPI assigned
Jul 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 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
Phone
(202) 382-2579

Specialties & licenses 1

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

Addresses

Primary practice location

813 East Lakeshore Drive
Manistique, MI 49854-1683

Mailing address

PO Box 94484
Cleveland, OH 44101-4484
Phone (608) 821-7200

Other names 1

  • MANISTIQUE VA CBOC Other name

National Provider Directory

National Provider Directory
Tax ID family
Iron Mountain Vamc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

813 E Lakeshore Dr
Manistique, MI 49854
Phone (906) 341-3420

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1114334174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94484",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014484",
            "telephone_number": "608-821-7200",
            "fax_number": "608-821-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "813 EAST LAKESHORE DRIVE",
            "city": "MANISTIQUE",
            "state": "MI",
            "postal_code": "498541683",
            "telephone_number": "608-821-7200",
            "fax_number": "608-821-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRON MOUNTAIN VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-22",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "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": "MANISTIQUE VA CBOC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "MANISTIQUE VA CBOC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Manistique, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 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.