NPIMap

Organization Active NPI

Bay Pines Vamc

  • VA Clinic/Center
  • Port Charlotte, FL
National Provider Identifier
1649219031
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
BAY PINES VAMC
Practice address
4161 Tamiami TRL
Unit 401
Port Charlotte, FL 33952-9204
Phone
(866) 793-4591
NPI assigned
Jun 4, 2006
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

4161 Tamiami TRL
Unit 401
Port Charlotte, FL 33952-9204

Mailing address

PO Box 94465
Cleveland, OH 44101-4465
Phone (866) 793-4591

Other names 1

  • Port Charlotte VA CBOC 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
10D0999475Port Charlotte Cboc4161 Tamiami, Port Charlotte, FL 33952AccreditationMay 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
Bay Pines 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

Locations

4161 Tamiami Trl
Ste 401
Port Charlotte, FL 33952
Phone (941) 235-2710

NPI Registry JSON

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679961600000",
    "number": "1649219031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94465",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014465",
            "telephone_number": "866-793-4591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4161 TAMIAMI TRL",
            "address_2": "UNIT 401",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339529204",
            "telephone_number": "866-793-4591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAY PINES VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "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": "Port Charlotte VA CBOC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Port Charlotte VA CBOC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Port Charlotte, FL

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.
  • 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.