NPIMap

Organization Active NPI

Danville Vamc

  • VA Clinic/Center
  • Bloomington, IL
National Provider Identifier
1609426709
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
DANVILLE VAMC
Practice address
207 E Hamilton Rd
Bloomington, IL 61704-7527
Phone
(608) 821-7200
Fax
(608) 821-7658
NPI assigned
Sep 19, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

207 E Hamilton Rd
Bloomington, IL 61704-7527

Mailing address

PO Box 94478
Cleveland, OH 44101-4478
Phone (608) 821-7200

Other names 1

  • BLOOMINGTON VA CLINIC Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2173863Bloomington VA Clinic207 Hamilton Road, Bloomington, IL 61704AccreditationMay 22, 2026

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

207 E Hamilton Rd
Bloomington, IL 61704
Phone (217) 274-8953

NPI Registry JSON

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1609426709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94478",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014478",
            "telephone_number": "608-821-7200",
            "fax_number": "608-821-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 E HAMILTON RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617047527",
            "telephone_number": "608-821-7200",
            "fax_number": "608-821-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "NPI TEAM",
        "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": "BLOOMINGTON VA CLINIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "BLOOMINGTON VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.