NPIMap

Organization Active NPI

Danville Vamc

  • VA Clinic/Center
  • Mattoon, IL
National Provider Identifier
1861725699
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
DANVILLE VAMC
Practice address
501 Lake Land Blvd
Mattoon, IL 61938
Phone
(608) 821-7200
Fax
(608) 821-7658
NPI assigned
Sep 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 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 Primary

Addresses

Primary practice location

501 Lake Land Blvd
Mattoon, IL 61938

Mailing address

PO Box 94478
Cleveland, OH 44101-4478
Phone (608) 821-7200

Other names 1

  • MATTOON VA CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
Danville 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

501 Lake Land Blvd
Mattoon, IL 61938
Phone (217) 258-3370

NPI Registry JSON

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

{
    "created_epoch": "1252627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1861725699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94478",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014478",
            "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": "501 LAKE LAND BLVD",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "61938",
            "telephone_number": "608-821-7200",
            "fax_number": "608-821-7658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANVILLE VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-11",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "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": "MATTOON VA CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mattoon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.