FAYETTEVILLE VAMC (NPI# 1417900671) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417900671 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE VAMC |
| Other Organization Name | MOUNT VERNON VA CBOC |
| Practice Address |
1850 W Republic Rd Springfield MO 65807-5730 |
| Mailing Address |
Po Box 94494 Cleveland OH 44101 |
| Practice Telephone | 6153553451 |
| Mailing Telephone | 6153553451 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-01-22 |
| 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 |
|---|---|
| Mount Vernon VA CBOC | Other Name - Individual/Organization |
| SPRINGFIELD 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 |
| 1114270212 | Fayetteville Vamc | Clinic/Center | 3112 Tramway Road, Sanford, NC 27332-9998 | 2012-10-26 |
| 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 |
| Street Address |
1850 W REPUBLIC RD |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-5730 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609856483 | Keith David Eiche | Psychologist | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2006-01-18 |
| 1275154106 | Tyler Thill | Optometrist | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2020-05-01 |
| 1821555368 | James Quentin Walsh | Social Worker | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2019-02-20 |
| 1902254063 | Brittany Lynn Setzer | Optometrist | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2016-05-31 |
| 1124430988 | Hilary Morrow Price | Optometrist | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2014-05-28 |
| 1659547800 | Fayetteville Vamc | Department of Veterans Affairs (VA) Pharmacy | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2008-05-07 |
| 1821297698 | Gretta Lynn Gilliam | Nurse Practitioner | 1850 W Republic Rd, Springfield, MO 65807-5730 | 2007-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902845316 | Dayton Vamc | Clinic/Center | 1620 N Limestone St, Springfield, OH 45503-2624 | 2006-06-05 |
| 1497098800 | Tram Thi Bui | Clinic/Center | 6501 Loisdale Ct, Springfield, VA 22150-1826 | 2013-04-03 |
| 1679626949 | Northampton Vamc | Clinic/Center | 25 Bond St, Springfield, MA 01104-3401 | 2007-01-19 |
| 1821015264 | Benjamin Adewale Md PC | Clinic/Center | 7011 Calamo St, #105, Springfield, VA 22150 | 2006-07-15 |
| 1982642823 | Northampton Vamc | Clinic/Center | 25 Bond St, Springfield, MA 01104-3401 | 2006-06-03 |
| 1235177973 | Danville Vamc | Clinic/Center | 5850 S 6th Street Rd, Frontage Road East - Suite A, Springfield, IL 62703-5162 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992264824 | Fayetteville Vamc | Clinic/Center | 3015 Connecticut Ave, Joplin, MO 64804-3035 | 2019-03-19 |
| 1538542188 | Kansas City Vamc | Clinic/Center | 2303 Higgins Road, Suite F, Platte City, MO 64079-7101 | 2015-07-01 |
| 1114317369 | St. Louis Jc Vamc | Clinic/Center | 2600 Washington Boulevard, St. Louis, MO 63103-1420 | 2015-01-27 |
| 1396135513 | St. Louis Jc Vamc | Clinic/Center | 3615 Olive Street, St. Louis, MO 63108-3604 | 2015-01-26 |
| 1487061446 | Kansas City Vamc | Clinic/Center | 4251 Northern Avenue, Kansas City, MO 64133-1593 | 2014-07-22 |
| 1902198922 | St. Louis Jc Vamc | Clinic/Center | 1627 A Roy Dr, Washington, MO 63090-5008 | 2011-05-10 |
| 1720301682 | Kansas City Vamc | Clinic/Center | 3320 W 10th St, Sedalia, MO 65301-2111 | 2010-03-08 |
| 1134375546 | Kansas City Vamc | Clinic/Center | 3430 W Edgewood Dr, Jefferson City, MO 65109-6961 | 2008-08-18 |
| 1518155878 | St. Louis Jc Vamc | Clinic/Center | 6854 Parker Rd, Florissant, MO 63033-5313 | 2007-10-11 |
| 1457394033 | Kansas City Vamc | Clinic/Center | 207 Matlock Drive, St. James, MO 65559-9998 | 2006-06-13 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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.