NPIMap

Organization Active NPI

Salt Lake City Vamc

  • VA Clinic/Center
  • North Logan, UT
National Provider Identifier
1659980316
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
SALT LAKE CITY VAMC
Practice address
2380 N 400 E Ste G
North Logan, UT 84341-1769
Phone
(913) 578-4409
Fax
(913) 578-4536
NPI assigned
Jul 29, 2020
Last updated
Jul 29, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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 Member
Phone
(202) 382-2579

Specialties & licenses 1

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

Addresses

Primary practice location

2380 N 400 E Ste G
North Logan, UT 84341-1769

Mailing address

PO Box 94463
Cleveland, OH 44101-4463
Phone (913) 578-4409

Other names 1

  • NORTH LOGAN VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Salt Lake City 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

2380 N 400 E
Ste G
North Logan, UT 84341
Phone (435) 753-9044

NPI Registry JSON

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

{
    "created_epoch": "1595980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1659980316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94463",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014463",
            "telephone_number": "913-578-4409",
            "fax_number": "913-578-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 N 400 E STE G",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411769",
            "telephone_number": "913-578-4409",
            "fax_number": "913-578-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALT LAKE CITY VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-29",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "DENISE",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH LOGAN VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in North Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2020; 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.