NPIMap

Organization Active NPI

Fayetteville Vamc

  • VA Clinic/Center
  • Jacksonville, NC
National Provider Identifier
1568417798
Registry record updated Apr 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
FAYETTEVILLE VAMC
Practice address
4006 Henderson Drive
Jacksonville, NC 28546-9998
Phone
(828) 257-3777
NPI assigned
May 24, 2006
Last updated
Apr 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2018

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

4006 Henderson Drive
Jacksonville, NC 28546-9998

Mailing address

PO Box 89494
Cleveland, OH 44101-6494
Phone (828) 257-2333

Other names 1

  • JACKSONVILLE 1 VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Fayetteville Vamc23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

Locations

4006 Henderson Dr
Jacksonville, NC 28546
Phone (910) 353-6406

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1568417798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 89494",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441016494",
            "telephone_number": "828-257-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4006 HENDERSON DRIVE",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285469998",
            "telephone_number": "828-257-3777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2018-04-11",
        "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": "JACKSONVILLE 1 VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Jacksonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.