NPIMap

Organization Active NPI

Clarksburg Vamc

  • VA Clinic/Center
  • Gassaway, WV
National Provider Identifier
1790739118
Registry record updated Apr 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
CLARKSBURG VAMC
Practice address
40 Reston PL
Gassaway, WV 26624-7899
Phone
(828) 257-2333
NPI assigned
May 20, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Erin Potter
Title
Npi Team Member
Phone
(202) 382-2579

Corporate family (same tax ID) 7

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

National Provider Directory

National Provider Directory
Tax ID family
Clarksburg Vamc (8 organizations share this tax ID)

Locations

40 Reston Pl
Gassaway, WV 26624

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

40 Reston PL
Gassaway, WV 26624-7899

Mailing address

PO Box 94436
Cleveland, OH 44101-4436
Phone (828) 257-2333

Other names 1

NPPES NPI Registry
  • Gassaway VA Clinic Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 17, 2018.

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523923200000",
    "number": "1790739118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94436",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014436",
            "telephone_number": "828-257-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 RESTON PL",
            "city": "GASSAWAY",
            "state": "WV",
            "postal_code": "266247899",
            "telephone_number": "828-257-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSBURG VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2018-04-17",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QV0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, VA",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gassaway VA Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Gassaway VA Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gassaway, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2018; 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.