Active NPI
Administration of Veterans Affairs
- VA Clinic/Center
- Fayetteville, NC
National Provider Identifier
1376250183
On this page
Key facts
NPPES NPI Registry- Primary specialty
- VA Clinic/Center
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| VA Clinic/Center | 261QV0200X | Primary | ||
| Primary Care Nurse Practitioner | 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 Affair
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Nurse Practitioner
- Fayetteville, NC
- NPI 1154038875
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.
-
- Nurse Practitioner
- Fayetteville, NC
- NPI 1659088375
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.