NPIMap

Organization Active NPI

Salt Lake City Vamc

  • VA Clinic/Center
  • Roosevelt, UT
National Provider Identifier
1124062898
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
SALT LAKE CITY VAMC
Practice address
245 W 200 N
Roosevelt, UT 84066-2740
Phone
(913) 578-4409
NPI assigned
Jun 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

245 W 200 N
Roosevelt, UT 84066-2740

Mailing address

PO Box 94463
Cleveland, OH 44101-4463
Phone (913) 578-4409

Other names 1

  • Roosevelt VA Clinic Other name

National Provider Directory

National Provider Directory
Tax ID family
Salt Lake City Vamc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

Locations

245 W 200 N
Roosevelt, UT 84066

NPI Registry JSON

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516147200000",
    "number": "1124062898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94463",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014463",
            "telephone_number": "913-578-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 W 200 N",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662740",
            "telephone_number": "913-578-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE CITY VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2018-01-17",
        "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": "Roosevelt VA Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Roosevelt, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.