NPIMap

Organization Active NPI

Daytona Beach VA Outpaitent Clinic

  • Clinic/Center
  • Daytona Beach, FL
National Provider Identifier
1225046626
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
ME 88745 Issued in FL
Legal business name
DAYTONA BEACH VA OUTPAITENT CLINIC
Practice address
551 National Health Care Dr
Daytona Beach, FL 32114-1495
Phone
(386) 323-7500
NPI assigned
Aug 3, 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
Dr. Roger H. BowerNPI 1699724807
Title
Chief Medical Officer
Phone
(386) 323-7542

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X ME 88745 FL Primary

Addresses

Primary practice location

551 National Health Care Dr
Daytona Beach, FL 32114-1495

Mailing address

6810 Plumpjack CT
Port Orange, FL 32128-4083
Phone (386) 233-9774

National Provider Directory

National Provider Directory
Tax ID family
VA Hospital107 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 10

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

Locations

551 National Health Care Dr
Daytona Beach, FL 32114
Phone (386) 323-7541

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225046626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6810 PLUMPJACK CT",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321284083",
            "telephone_number": "386-233-9774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 NATIONAL HEALTH CARE DR",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321141495",
            "telephone_number": "386-323-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAYTONA BEACH VA OUTPAITENT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOWER",
        "authorized_official_first_name": "ROGER",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "386-323-7542",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": "ME 88745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.