NPIMap

Organization Active NPI

Indianapolis Vamc

  • VA Clinic/Center
  • Bloomington, IN
National Provider Identifier
1790173078
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
INDIANAPOLIS VAMC
Practice address
1332 Arch Haven Avenue
Bloomington, IN 47403-2079
Phone
(608) 821-7200
Fax
(608) 821-7658
NPI assigned
Jan 8, 2015
Last updated
Feb 24, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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 NU Primary

Addresses

Primary practice location

1332 Arch Haven Avenue
Bloomington, IN 47403-2079

Mailing address

PO Box 94483
Cleveland, OH 44101-4483
Phone (608) 821-7200

Other names 1

  • BLOOMINGTON 1 VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Indianapolis Vamc16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

1332 W Arch Haven Ave
Bloomington, IN 47403
Phone (812) 333-7447

NPI Registry JSON

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1790173078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94483",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014483",
            "telephone_number": "608-821-7200",
            "fax_number": "608-821-7658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 ARCH HAVEN AVENUE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032079",
            "telephone_number": "608-821-7200",
            "fax_number": "608-821-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDIANAPOLIS VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BLOOMINGTON 1 VA CLINIC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "BLOOMINGTON 1 VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; 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.