MADISON VAMC (NPI# 1033177589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033177589 |
| Entity Type | Organization |
| Organization Name | MADISON VAMC |
| Other Organization Name | ROCKFORD VA CBOC PHARMACY |
| Practice Address |
816 Featherstone Rd Rockford IL 61107-6300 |
| Mailing Address |
Po Box 5117 Madison WI 53705-0117 |
| Practice Telephone | 8152270081 |
| Practice Fax Number | 8153875314 |
| Mailing Telephone | 6088217200 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2020-08-11 |
| Authorized Official Name | ERIN POTTER (NPI TEAM MEMBER) |
| Authorized Official Telephone | 2023822579 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332100000X | Department of Veterans Affairs (VA) Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | NCPDP# | 1478444 | 01 |
| Other Name | Type Code |
|---|---|
| ROCKFORD VA CBOC PHARMACY | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124074810 | Madison Vamc | Clinic/Center | 1141 Black Bridge Rd, Janesville, WI 53545-1092 | 2006-05-25 |
| 1972554913 | Madison Vamc | Clinic/Center | 1670 South Blvd., Baraboo, WI 53913-2991 | 2006-05-15 |
| 1558721860 | Madison Vamc | Skilled Nursing Facility | 2500 Overlook Terrace, Madison, WI 53705-2254 | 2016-02-29 |
| 1023425089 | Madison Vamc | Clinic/Center | 1 Science Court, Madison, WI 53711-1055 | 2014-07-22 |
| 1558414987 | Madison Vamc | Clinic/Center | 750 Kiwanis Dr, Suite 250, Freeport, IL 61032-7119 | 2007-01-19 |
| 1174567770 | Madison Vamc | Clinic/Center | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2006-06-15 |
| 1992758254 | Madison Vamc | Clinic/Center | 215 Corporate Dr, Suite B, Beaver Dam, WI 53916-3123 | 2006-05-18 |
| 1275583619 | Madison Vamc | General Acute Care Hospital | 2500 Overlook Ter, Madison, WI 53705-2254 | 2006-05-10 |
| 1033177787 | Madison Vamc | Department of Veterans Affairs (VA) Pharmacy | 2500 Overlook Ter, Madison, WI 53705-2254 | 2006-05-03 |
| Street Address |
816 FEATHERSTONE RD |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-6300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952941833 | Amanda J Fruen | Nurse Practitioner | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2020-01-08 |
| 1770126187 | Daniel Kickertz | Pharmacist | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2019-10-18 |
| 1568027365 | Jan Lori Vogeler | Counselor | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2019-05-07 |
| 1285298901 | Kahseem Edward Ward | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2019-04-29 |
| 1659843852 | Melissa Lynn | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2018-12-28 |
| 1124590906 | Aimee Michelle Jerding | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2018-12-18 |
| 1174004998 | Jessica Mari Syversen | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2018-08-29 |
| 1033627526 | Tavares Moore | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2018-01-18 |
| 1679088124 | Kourtney Fermanich | Pharmacist | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2017-12-06 |
| 1386195634 | Sarah Ostrum | Social Worker | 816 Featherstone Rd, Rockford, IL 61107-6300 | 2016-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 332100000X |
| Grouping | Suppliers |
| Classification | Department of Veterans Affairs (VA) Pharmacy |
| Department of Veterans Affairs (VA) Pharmacy means any place under VA jurisdiction where drugs are dispensed and Pharmaceutical Care is provided to enrolled Veterans, by licensed pharmacists. The Pharmacy is reviewed by JCAHO, utilizes the VA hospital’s DEA number, and has a designated NCPDP number. VA facility pharmacies include Inpatient (Institutional), Outpatient, Consolidated Mail Outpatient Pharmacies (CMOPs), Research, Addiction Treatment Centers, Long Term Care and Community Based Outpatient Clinics Pharmacies. The VHA Pharmacy Benefits Management - Strategic Healthcare Group has oversight for professional and practice activities of VA Pharmacies. Each pharmacy is under the direct supervision of a U.S. or U.S. territory licensed pharmacist, and has staffing to meet its designated scope of service. |
| Notes: Source: Pharmacy Benefits Management – Strategic Healthcare Group, Veterans Health Administration, Department of Veterans Affairs [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114354537 | Emerling Inc | Department of Veterans Affairs (VA) Pharmacy | 102 W Park St, Taylorville, IL 62568-1547 | 2013-09-30 |
| 1700834116 | Hines Va Cmop | Department of Veterans Affairs (VA) Pharmacy | 5000 S 5th Ave, Bldg. 37, Hines, IL 60141-3030 | 2006-05-05 |
| 1518915172 | Chicago Vamc | Department of Veterans Affairs (VA) Pharmacy | 820 S Damen Ave, Chicago, IL 60612-3728 | 2006-05-05 |
| 1336197284 | Danville Vamc | Department of Veterans Affairs (VA) Pharmacy | 7717 N Orange Prairie Rd, Peoria, IL 61615-9323 | 2006-05-04 |
| 1396793378 | Hines Vamc | Department of Veterans Affairs (VA) Pharmacy | 5000 S 5th Ave, Hines, IL 60141-3030 | 2006-05-04 |
| 1750349429 | St. Louis Jc Vamc | Department of Veterans Affairs (VA) Pharmacy | 2401 W Main St, Marion, IL 62959-1188 | 2006-05-03 |
| 1326006933 | James A Lovell Federal Health Care Center | Department of Veterans Affairs (VA) Pharmacy | 3001 Green Bay Rd, North Chicago, IL 60064-3048 | 2006-05-03 |
| 1508824418 | Danville Vamc | Department of Veterans Affairs (VA) Pharmacy | 1900 E Main St, Danville, IL 61832-5100 | 2006-05-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.