NPIMap

Organization Active NPI

Jack C. Montgomery VA Medical Center

  • Voluntary or Charitable Agency
  • Muskogee, OK
National Provider Identifier
1467730952
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Voluntary or Charitable AgencyTaxonomy code 251V00000X
Legal business name
JACK C. MONTGOMERY VA MEDICAL CENTER
Practice address
102 York Village Dr
Apt 1
Muskogee, OK 74403-4843
Phone
(918) 616-4626
NPI assigned
Aug 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Authorized official

Name
Gregory Sorenson
Title
Chief, Voluntary Services
Phone
(918) 577-3621

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Voluntary or Charitable Agency 251V00000X Primary

Addresses

Primary practice location

102 York Village Dr
Apt 1
Muskogee, OK 74403-4843

Mailing address

102 York Village Dr
Apt 1
Muskogee, OK 74403-4843
Phone (918) 616-4626

National Provider Directory

National Provider Directory
Tax ID family
Muskogee Vamc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312156800000",
    "number": "1467730952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 YORK VILLAGE DR",
            "address_2": "APT 1",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744034843",
            "telephone_number": "918-616-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 YORK VILLAGE DR",
            "address_2": "APT 1",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744034843",
            "telephone_number": "918-616-4626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK C. MONTGOMERY VA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-08-01",
        "status": "A",
        "authorized_official_last_name": "SORENSON",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "CHIEF, VOLUNTARY SERVICES",
        "authorized_official_telephone_number": "918-577-3621"
    },
    "taxonomies": [
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 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.