NPIMap

Organization Active NPI

Department of Veterans Affairs

  • VA Clinic/Center
  • Decatur, IL
National Provider Identifier
1538398656
Registry record updated Jul 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
License
164000383 Issued in IL
Legal business name
DEPARTMENT OF VETERANS AFFAIRS
Practice address
3035 E Mound Rd
Decatur, IL 62526-9650
Phone
(217) 875-2670
NPI assigned
Jul 10, 2009
Last updated
Jul 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2009

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

Authorized official

Name
Debbie Tabels
Title
Credentialing & Privileging
Phone
(217) 554-5383

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
VA Clinic/Center 261QV0200X 164000383 IL Primary

Addresses

Primary practice location

3035 E Mound Rd
Decatur, IL 62526-9650

Mailing address

3035 E Mound Rd
Decatur, IL 62526-9650
Phone (217) 875-2670

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.

Locations

3035 E Mound Rd
Decatur, IL 62526
Phone (217) 554-3000

Practitioners & affiliated clinicians

Practitioners 5

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": "1247184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247184000000",
    "number": "1538398656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3035 E MOUND RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269650",
            "telephone_number": "217-875-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3035 E MOUND RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269650",
            "telephone_number": "217-875-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-10",
        "last_updated": "2009-07-10",
        "status": "A",
        "authorized_official_last_name": "TABELS",
        "authorized_official_first_name": "DEBBIE",
        "authorized_official_title_or_position": "CREDENTIALING & PRIVILEGING",
        "authorized_official_telephone_number": "217-554-5383"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": "IL",
            "license": "164000383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; 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.