VA Medical Center

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

RN2047752 Issued in FL

Legal business name

VA MEDICAL CENTER

Practice address

1920 Mason Ave
Emory L Bennett VA Nursing Home
Daytona Beach, FL 32117-5103

Phone

(386) 274-3460

NPI assigned

Aug 16, 2007

Organization subpart

No

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

Authorized official

Name

Miss Patricia Renee Anderson

Title

RN

Phone

(386) 916-6755

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187222400000",
    "number": "1649462359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16840 SE 52ND PL",
            "city": "OCKLAWAHA",
            "state": "FL",
            "postal_code": "321792836",
            "telephone_number": "386-916-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 MASON AVE",
            "address_2": "EMORY L BENNETT VA NURSING HOME",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175103",
            "telephone_number": "386-274-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VA MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-08-16",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "RN",
        "authorized_official_telephone_number": "386-916-6755",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "RN2047752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Skilled Nursing Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2007; 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.