NPIMap

Organization Active NPI

Danville Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Peoria, IL
National Provider Identifier
1336197284
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Department of Veterans Affairs (VA) PharmacyTaxonomy code 332100000X
Legal business name
DANVILLE VAMC
Practice address
7717 N Orange Prairie Rd
Peoria, IL 61615-9323
Phone
(309) 589-6800
Fax
(309) 589-6996
NPI assigned
May 4, 2006
Last updated
Sep 25, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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
Phone
(202) 382-2579

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Department of Veterans Affairs (VA) Pharmacy 332100000X NU Primary

Addresses

Primary practice location

7717 N Orange Prairie Rd
Peoria, IL 61615-9323

Mailing address

PO Box 94478
Cleveland, OH 44101-4478
Phone (608) 821-7200

Other identifiers 1

IdentifierTypeStateIssuer
1476313OtherILNCPDP#

Other names 1

  • PEORIA VA CLINIC PHARMACY Other name

National Provider Directory

National Provider Directory
Tax ID family
Danville 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.

Practitioners & affiliated clinicians

Practitioners 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695600000000",
    "number": "1336197284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94478",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014478",
            "telephone_number": "608-821-7200",
            "fax_number": "608-821-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7717 N ORANGE PRAIRIE RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616159323",
            "telephone_number": "309-589-6800",
            "fax_number": "309-589-6996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "NPI TEAM",
        "authorized_official_telephone_number": "202-382-2579"
    },
    "taxonomies": [
        {
            "code": "332100000X",
            "taxonomy_group": "",
            "desc": "Department of Veterans Affairs (VA) Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP#",
            "identifier": "1476313",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEORIA VA CLINIC PHARMACY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.