Organization Active NPI

Administration of Veterans Affairs

  • VA Clinic/Center
  • Fayetteville, NC
National Provider Identifier
1376250183
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
ADMINISTRATION OF VETERANS AFFAIRS
Practice address
7300 S Raeford Rd
Fayetteville, NC 28304-6162
Phone
(910) 488-2120
NPI assigned
Nov 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Authorized official

Name
Debra Young
Title
Manager
Phone
(910) 488-2120

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X Primary
Primary Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP2300X

Addresses

Primary practice location

7300 S Raeford Rd
Fayetteville, NC 28304-6162

Mailing address

7300 S Raeford Rd
Fayetteville, NC 28304-6162
Phone (910) 488-2120

National Provider Directory

National Provider Directory
Tax ID family
Administration of Veterans Affair2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

7300 S Raeford Rd
Fayetteville, NC 28304
Phone (910) 475-6412

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": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1376250183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 S RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283046162",
            "telephone_number": "910-488-2120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 S RAEFORD RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283046162",
            "telephone_number": "910-488-2120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADMINISTRATION OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "910-488-2120"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.