NPIMap

Organization Active NPI

Gainesville Vamc

  • VA Clinic/Center
  • Waycross, GA
National Provider Identifier
1407263452
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
GAINESVILLE VAMC
Practice address
515B City Boulevard
Waycross, GA 31501-8016
Phone
(866) 793-4591
NPI assigned
Jul 22, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

515B City Boulevard
Waycross, GA 31501-8016

Mailing address

PO Box 94468
Cleveland, OH 44101-4468
Phone (866) 793-4591

Other names 1

  • WAYCROSS VA CBOC Other name

National Provider Directory

National Provider Directory
Tax ID family
Gainesville Vamc34 organizations share this tax ID, including this one

Other organizations with this tax ID 33

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

View all 33

Locations

515 City Blvd
Ste B
Waycross, GA 31501
Phone (912) 279-4400

NPI Registry JSON

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

{
    "created_epoch": "1405987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1407263452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94468",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014468",
            "telephone_number": "866-793-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515B CITY BOULEVARD",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315018016",
            "telephone_number": "866-793-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINESVILLE VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-22",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "NPI TEAM MEMBER",
        "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": "WAYCROSS VA CBOC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "WAYCROSS VA CBOC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Waycross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.