Organization Active NPI

St. Louis JC Vamc

  • VA Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1902685159
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
VA Clinic/CenterTaxonomy code 261QV0200X
Legal business name
ST. LOUIS JC VAMC
Practice address
1 Jefferson Barracks Dr
St. Louis, MO 63125-4181
Phone
(913) 578-4409
Fax
(913) 578-4536
NPI assigned
Sep 27, 2023
Last updated
Sep 27, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

1 Jefferson Barracks Dr
St. Louis, MO 63125-4181

Mailing address

PO Box 94462
Cleveland, OH 44101-4462
Phone (913) 578-4409

Other names 1

  • ST. LOUIS VA MOBILE CLINIC Other name

National Provider Directory

National Provider Directory
Tax ID family
St Louis JC Vamc45 organizations share this tax ID, including this one

Other organizations with this tax ID 44

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

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1695772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695772800000",
    "number": "1902685159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 94462",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441014462",
            "telephone_number": "913-578-4409",
            "fax_number": "913-578-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DR",
            "city": "ST. LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "913-578-4409",
            "fax_number": "913-578-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS JC VAMC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "DENISE",
        "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": "ST. LOUIS VA MOBILE CLINIC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 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.