NPIMap

Organization Active NPI

Phoenix Vamc

  • VA Clinic/Center
  • Mesa, AZ
National Provider Identifier
1295456358
Registry record updated Sep 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
PHOENIX VAMC
Practice address
4135 S Power Rd Ste 103
Mesa, AZ 85212-3625
Phone
(702) 341-3152
Fax
(702) 341-3503
NPI assigned
Sep 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2022

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

Authorized official

Name
Erin Denise Potter
Title
Npi Team Lead
Phone
(202) 382-2579

Specialties & licenses 1

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

Addresses

Primary practice location

4135 S Power Rd Ste 103
Mesa, AZ 85212-3625

Mailing address

PO Box 94413
Cleveland, OH 44101-4413
Phone (702) 341-3152

Other names 1

  • MESA VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Phoenix Vamc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Locations

4135 S Power Rd
Ste 103
Mesa, AZ 85212
Phone (480) 397-2800

NPI Registry JSON

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662508800000",
    "number": "1295456358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94413",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014413",
            "telephone_number": "702-341-3152",
            "fax_number": "702-341-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 S POWER RD STE 103",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852123625",
            "telephone_number": "702-341-3152",
            "fax_number": "702-341-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "NPI TEAM LEAD",
        "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": "MESA VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.