NPIMap

Organization Active NPI

Loma Linda Vamc

  • VA Clinic/Center
  • Victorville, CA
National Provider Identifier
1689613507
Registry record updated Dec 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
LOMA LINDA VAMC
Practice address
14598 Seventh St Ste B
Victorville, CA 92395-4214
Phone
(702) 341-3152
NPI assigned
Jun 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2021

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

Authorized official

Name
Ms. 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

14598 Seventh St Ste B
Victorville, CA 92395-4214

Mailing address

PO Box 94409
Cleveland, OH 44101-4409
Phone (702) 341-3152

Other names 1

  • Victorville 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
05D2239919Victorville VA Clinic14598 7TH St Suite B, Victorville, CA 92395Certificate of waiverOct 13, 2027
05D2342465Victorville VA Clinic14598 7TH Street Suite B, Victorville, CA 92395AccreditationMay 22, 2026

National Provider Directory

National Provider Directory
Tax ID family
Loma Linda Vamc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

14598 Seventh St
#B
Victorville, CA 92395

12138 Industrial Blvd
Ste 120
Victorville, CA 92395
Phone (760) 951-2599

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639699200000",
    "number": "1689613507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94409",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014409",
            "telephone_number": "702-341-3152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14598 SEVENTH ST STE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923954214",
            "telephone_number": "702-341-3152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOMA LINDA VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-06",
        "last_updated": "2021-12-17",
        "certification_date": "2021-12-17",
        "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",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victorville VA Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2021; 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.