John J. Pershing Vamc

Primary specialty

Rural Acute Care HospitalTaxonomy code 282NR1301X

License

2015006783 Issued in MO

Legal business name

JOHN J. PERSHING VAMC

Practice address

1500 N Westwood Blvd
Poplar Bluff, MO 63901-3318

Phone

(573) 686-4151

Fax

(573) 778-4190

NPI assigned

Mar 17, 2015

Organization subpart

No

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

Authorized official

Name

Bradford Joseph Davis, FNP

Title

Family Nurse Practitioner

Phone

(573) 776-0905

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1426550400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1659764595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013318",
            "telephone_number": "573-686-4151",
            "fax_number": "573-778-4190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N WESTWOOD BLVD",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639013318",
            "telephone_number": "573-686-4151",
            "fax_number": "573-778-4190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN J. PERSHING VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-17",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "FAMILY NURSE PRACTITIONER",
        "authorized_official_telephone_number": "573-776-0905",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "282NR1301X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Rural",
            "state": "MO",
            "license": "2015006783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Jennings, BS
• Marylee Jennings, PSY.D.
• Hana Vivian Jeong, DMD
• John J Pershing VA Medical Center
• John J Pershing VA Medical Center
• John O. Wood Psychological Services
• Sandy D Johns, WHNP-BC
• Amy Leigh Johnson-Robinson
• Ashlyn Johnson
• Jarrica Lynn Johnson, LMSW

• Rural Acute Care Hospital in Poplar Bluff, MO
• Providers in Poplar Bluff, MO by specialty
• Rural Acute Care Hospital in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.