Department of Veterans Affairs

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

1096474 Issued in KY

Legal business name

DEPARTMENT OF VETERANS AFFAIRS

Practice address

209 Pauline Dr
Berea, KY 40403-8889

Phone

(859) 233-4511

Fax

(859) 986-1289

NPI assigned

May 27, 2011

Last updated

May 27, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lydia Gregory, RN

Title

Staff Nurse

Phone

(859) 233-4511

Specialties & licenses 1

Addresses

Locations

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.

• Hannah Bennett, MD

  • Internal Medicine Physician
  • Berea, KY
  • NPI 1194187633
  NPD (past)

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306454400000",
    "number": "1326331083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 PAULINE DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404038889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 PAULINE DR",
            "city": "BEREA",
            "state": "KY",
            "postal_code": "404038889",
            "telephone_number": "859-233-4511",
            "fax_number": "859-986-1289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-27",
        "last_updated": "2011-05-27",
        "status": "A",
        "authorized_official_last_name": "GREGORY",
        "authorized_official_first_name": "LYDIA",
        "authorized_official_title_or_position": "STAFF NURSE",
        "authorized_official_telephone_number": "859-233-4511",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "KY",
            "license": "1096474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terri Susan Daugherty, RN
• Benjamin Phillip Davis
• Gary Ralph Davis, LCSW
• Sandra Hope Davis, LCSW
• Leigh A Delair, MD
• Adam Lee Deshong, APRN
• Leslie Paige Allen Devers, DO
• Ma Joy Sandra Buenafe Dionisio, M.D.
• Shannon Downing
• Mary Downs, LMT

• Primary Care Clinic/Center in Berea, KY
• Providers in Berea, KY by specialty
• Primary Care Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2011; 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.