NPIMap

Organization Active NPI

Prescott Vamc

  • VA Clinic/Center
  • Lake Havasu City, AZ
National Provider Identifier
1720034697
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
PRESCOTT VAMC
Practice address
145 Park Ave
Lake Havasu City, AZ 86403-9302
Phone
(702) 341-3152
Fax
(702) 341-3503
NPI assigned
May 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
Erin Potter
Title
Npi Team
Phone
(202) 382-2579

Specialties & licenses 1

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

Addresses

Primary practice location

145 Park Ave
Lake Havasu City, AZ 86403-9302

Mailing address

PO Box 94411
Cleveland, OH 44101-4411
Phone (702) 341-3152

Other names 1

  • LAKE HAVASU VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Prescott 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

145 Park Ave
Lake Havasu City, AZ 86403

2035 Mesquite Ave
Ste D
Lk Havasu Cty, AZ 86403
Phone (520) 680-2846

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1720034697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94411",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014411",
            "telephone_number": "702-341-3152",
            "fax_number": "702-341-3503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PARK AVE",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864039302",
            "telephone_number": "702-341-3152",
            "fax_number": "702-341-3503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESCOTT VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_title_or_position": "NPI TEAM",
        "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": "LAKE HAVASU VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lake Havasu City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.