Active NPI
St. Louis JC Vamc
- VA Clinic/Center
- Saint Louis, MO
National Provider Identifier
1902685159
On this page
Key facts
NPPES NPI Registry- Primary specialty
- VA Clinic/Center
- 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, 2023
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
National Provider Directory
National Provider Directory- Tax ID family
- St Louis JC Vamc
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-
- Department of Veterans Affairs (VA) Pharmacy
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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.