FAYETTEVILLE VAMC (NPI# 1114270212) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114270212 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE VAMC |
| Other Organization Name | SANFORD VA CLINIC |
| Practice Address |
3112 Tramway Road Sanford NC 27332-9998 |
| Mailing Address |
Po Box 89494 Cleveland OH 44101-6494 |
| Practice Telephone | 8282573777 |
| Mailing Telephone | 8282572333 |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2018-04-11 |
| 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 | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| SANFORD VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992264824 | Fayetteville Vamc | Clinic/Center | 3015 Connecticut Ave, Joplin, MO 64804-3035 | 2019-03-19 |
| 1659879138 | Fayetteville Vamc | Clinic/Center | 4 Josh Ct, Jacksonville, NC 28546-0052 | 2018-01-30 |
| 1194256362 | Fayetteville Vamc | Clinic/Center | 4101 Raeford Road, Suite 100-b, Fayetteville, NC 28304-4114 | 2017-03-21 |
| 1528456811 | Fayetteville Vamc | Clinic/Center | 216 East Township Street, Fayetteville, AR 72703-2818 | 2015-01-08 |
| 1124422308 | Fayetteville Vamc | Clinic/Center | 306 Brynn Marr Rd, Jacksonville, NC 28546-7023 | 2014-10-16 |
| 1962819052 | Fayetteville Vamc | Clinic/Center | 18 Doctors Cir Ste 2, Supply, NC 28462-4089 | 2014-07-21 |
| 1912201146 | Fayetteville Vamc | Clinic/Center | 139 Three Hunts Drive, Pembroke, NC 28372-6800 | 2011-01-03 |
| 1831415751 | Fayetteville Vamc | Clinic/Center | 2713 W Commercial St, Ozark, AR 72949-3409 | 2010-04-16 |
| 1568417798 | Fayetteville Vamc | Clinic/Center | 4006 Henderson Drive, Jacksonville, NC 28546-9998 | 2006-05-24 |
| 1538799002 | Fayetteville Vamc | Clinic/Center | 2580 Henderson Dr, Jacksonville, NC 28546-5252 | 2020-01-23 |
| Street Address |
3112 TRAMWAY ROAD |
| City | SANFORD |
| State | NC |
| Zip Code | 27332-9998 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932629847 | Jessica Lane Phillips | Specialist/Technologist | 17 Cypress Creek Farm Rd, Sanford, NC 27332 | 2017-06-21 |
| 1033557012 | Krishawn Davis-darby | Student in an Organized Health Care Education/Training Program | 5593 Olivia Rd, Sanford, NC 27332 | 2013-06-12 |
| 1144593898 | Fetima Marie Wellington | Counselor | 310 Timberline Dr, Sanford, NC 27332 | 2012-02-10 |
| 1740588383 | Food Lion, LLC | Durable Medical Equipment & Medical Supplies | 1655 Buffalo Lake Road, Sanford, NC 27332 | 2011-03-07 |
| 1912057282 | Susan Kay Byerly | Psychologist | 226 E Trade St, Sanford, NC 27332 | 2007-01-11 |
| 1265503601 | David A Edrington Dds Pa | Dentist | 420 West Main Street, Sanford, NC 27332 | 2006-11-09 |
| 1396840625 | Knecht Chiropractic Center PC | Chiropractor | 2631 South Horner Boulevard, Sanford, NC 27332 | 2006-09-13 |
| 1861446338 | Liberty Healthcare Group LLC | Skilled Nursing Facility | 310 Commerce Drive, Sanford, NC 27332 | 2006-05-20 |
| 1700863271 | Vincent Paul Vissichelli | Dentist | 73 Pineridge Cove, Sanford, NC 27332 | 2005-12-27 |
| 1992787832 | Tenet Central Carolina Physicians Inc | Internal Medicine | 4546 Hwy 87 S, Sanford, NC 27332 | 2005-11-16 |
| Find all providers in zip 27332 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003446105 | Durham Vamc | Clinic/Center | 11618 Us 70 Business Highway West, Suites 100 and 200, Clayton, NC 27520-2275 | 2020-01-17 |
| 1659879138 | Fayetteville Vamc | Clinic/Center | 4 Josh Ct, Jacksonville, NC 28546-0052 | 2018-01-30 |
| 1194256362 | Fayetteville Vamc | Clinic/Center | 4101 Raeford Road, Suite 100-b, Fayetteville, NC 28304-4114 | 2017-03-21 |
| 1457719312 | Salisbury Vamc | Clinic/Center | 3506 W Tyvola Road, Charlotte, NC 28208-9998 | 2016-02-08 |
| 1609274943 | Durham Vamc | Clinic/Center | 8081 Arco Corporate Dr, Suite 103, Raleigh, NC 27617-2041 | 2014-12-19 |
| 1124422308 | Fayetteville Vamc | Clinic/Center | 306 Brynn Marr Rd, Jacksonville, NC 28546-7023 | 2014-10-16 |
| 1962819052 | Fayetteville Vamc | Clinic/Center | 18 Doctors Cir Ste 2, Supply, NC 28462-4089 | 2014-07-21 |
| 1174800585 | Hampton Vamc | Clinic/Center | 1845 West City Drive, Elizabeth City, NC 27909-9633 | 2011-11-14 |
| 1912201146 | Fayetteville Vamc | Clinic/Center | 139 Three Hunts Drive, Pembroke, NC 28372-6800 | 2011-01-03 |
| 1811225428 | Asheville Vamc | Clinic/Center | 2270 College Ave Ste 145, Forest City, NC 28043-2459 | 2009-11-20 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on FAYETTEVILLE VAMC.
| 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.