NPIMap

Organization Active NPI

Florida Department of Veterans Affairs

Doing business as Clyde E Lassen State Veterans Nursing Home

  • Skilled Nursing Facility
  • St Augustine, FL
National Provider Identifier
1912215583
Registry record updated Jul 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
PH24880 Issued in FL
Legal business name
FLORIDA DEPARTMENT OF VETERANS AFFAIRS
Practice address
4650 State Road 16
Saint Augustine, FL 32092-0600
Phone
(904) 940-2193
Fax
(904) 940-0316
NPI assigned
Sep 17, 2010
Last updated
Jul 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2026

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

Authorized official

Name
Ms. Barbara Jean Paulison, PHARMD
Title
Pharmacy Manager
Phone
(904) 940-2193

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X PH24880 FL Primary

Addresses

Primary practice location

4650 State Road 16
Saint Augustine, FL 32092-0600

Mailing address

4650 State Road 16
Saint Augustine, FL 32092-0600
Phone (904) 940-2193

Other names 1

  • Clyde E Lassen State Veterans Nursing Home Other name

National Provider Directory

National Provider Directory
Tax ID family
Emory L Bennett VA Pharmacy12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1284681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783468800000",
    "number": "1912215583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 STATE ROAD 16",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320920600",
            "telephone_number": "904-940-2193",
            "fax_number": "904-940-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 STATE ROAD 16",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320920600",
            "telephone_number": "904-940-2193",
            "fax_number": "904-940-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORIDA DEPARTMENT OF VETERANS AFFAIRS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-17",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A",
        "authorized_official_last_name": "PAULISON",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "904-940-2193",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "PH24880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clyde E Lassen State Veterans Nursing Home",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clyde E Lassen State Veterans Nursing Home",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2026; 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.