St. Cloud Vamc

Primary specialty

VA Clinic/CenterTaxonomy code 261QV0200X

Legal business name

ST. CLOUD VAMC

Practice address

814 N 11TH St
Montevideo, MN 56265-1629

Phone

(913) 578-4409

Fax

(913) 578-4536

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Addresses

Other names 1

• MONTEVIDEO VA CLINIC Other name

Tax ID family

St Cloud Vamc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• St. Cloud Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Saint Cloud, MN
  • NPI 1235187741
  NPD tax ID
• St. Cloud Vamc

  • General Acute Care Hospital
  • Saint Cloud, MN
  • NPI 1588614325
  NPD tax ID
• St. Cloud Vamc

  • VA Clinic/Center
  • Brainerd, MN
  • NPI 1871640839
  NPD tax ID
• St. Cloud Vamc

  • VA Clinic/Center
  • Alexandria, MN
  • NPI 1942431242
  NPD tax ID

Locations

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1124175179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94461",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014461",
            "telephone_number": "913-578-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 N 11TH ST",
            "city": "MONTEVIDEO",
            "state": "MN",
            "postal_code": "562651629",
            "telephone_number": "913-578-4409",
            "fax_number": "913-578-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLOUD VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "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": "MONTEVIDEO VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Justin Lynn Schomerus, PHARMD
• Kristine Suzanne Schularick, NREMT-P, RN
• Michelle Schuldt, APRN, CNP
• Shoptikal LLC
• Amy L Sippl, B.C.B.A.
• Brandi Lee Stallman, ADT
• State of Minnesota - Minnesota Management and Budget
• State of Minnesota - Minnesota Management and Budget
• Ashley Brooke Stengel
• Jessica A Stettner, NP

• VA Clinic/Center in Montevideo, MN
• Providers in Montevideo, MN by specialty
• VA Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.