VA MEDICAL CENTER (NPI# 1497953012) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497953012 |
| Entity Type | Organization |
| Organization Name | VA MEDICAL CENTER |
| Practice Address |
1401 Post Oak Dr Apt F Clarkston GA 30021-3145 |
| Mailing Address |
Po Box 33622 Decatur GA 30033-0622 |
| Practice Telephone | 4048083229 |
| Mailing Telephone | 4048083229 |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. LEA MICHELLE WALKER (LPN) |
| Authorized Official Telephone | 4048083229 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 286500000X | Military Hospital | LPN074690 | GA | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245785179 | Va Medical Center | Military Hospital | 5939 Cedros Ave Apt A, Van Nuys, CA 91411-3104 | 2016-08-21 |
| 1104216332 | Va Medical Center | Military Hospital | 10707 W Interstate 10 Apt 436, San Antonio, TX 78230-1674 | 2015-01-26 |
| 1295178796 | Va Medical Center | Military Hospital | 16 Charles St, 3rd Floor, Lincoln, RI 02865-1906 | 2013-04-15 |
| 1487905311 | Va Medical Center | General Acute Care Hospital | 292 Sherwood Dr, Huntington, WV 25704-9460 | 2012-10-02 |
| 1033479316 | Va Medical Center | Chronic Disease Hospital | 500 Trinity Ln N Apt 5204, St Petersburg, FL 33716-1236 | 2012-05-21 |
| 1134495682 | Va Medical Center | General Acute Care Hospital | 5015 S Desoto Ct, New Berlin, WI 53151-7664 | 2012-03-29 |
| 1386952893 | Va Medical Center | General Acute Care Hospital | 6208 Krandon Drive, Raleigh, NC 27603-4928 | 2010-09-17 |
| 1093049520 | Va Medical Center | Military Hospital | 5416 Orange Valley Dr, Lakeland, FL 33813-2649 | 2009-09-30 |
| 1275784050 | Va Medical Center | Skilled Nursing Facility | 236 Pochin Pl, Hampton, VA 23661-2902 | 2008-10-10 |
| 1154587475 | Va Medical Center | General Acute Care Hospital | 4001 24th Ave W, Seattle, WA 98199-1505 | 2008-08-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VA MEDICAL CENTER | 4101 Woolworth Ave, Omaha, NE 68105-1850 |
| System for Award Management (SAM) Entities | VA MEDICAL CENTER 581/90C | 1540 Spring Valley Dr, Huntington, WV 25704-9300 |
| Street Address |
1401 POST OAK DR APT F |
| City | CLARKSTON |
| State | GA |
| Zip Code | 30021-3145 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578081808 | Marqueta A Coffer | Case Manager/Care Coordinator | 1380 Brockett Pl, Clarkston, GA 30021 | 2017-09-07 |
| 1063965143 | Bertukan Worku Demas | Pharmacist | 3671 Cobble Mill Ln, Clarkston, GA 30021 | 2016-07-26 |
| 1912341967 | Esther Kim | Family Medicine | 887 N Indian Creek Dr Ste A, Clarkston, GA 30021 | 2013-04-22 |
| 1265739437 | Carepoint Home Care, LLC | In Home Supportive Care | 4122 E Ponce Deleon Avenue, Unit 9, Clarkston, GA 30021 | 2011-02-23 |
| 1790956530 | Thu D. Vu | Dentist | 3596 Hill Street, Clarkston, GA 30021 | 2008-03-20 |
| 1740310630 | Gentle Dental | Dentist | 3595 Hill St., Clarkston, GA 30021 | 2007-03-07 |
| 1679528491 | Ojoru Osunkoya | Pediatrics | 4112 E. Ponce De Leon, Clarkston, GA 30021 | 2006-05-23 |
| 1700849825 | Regina Allen Hardin | Pediatrics | 4112 E. Ponce De Leon Avenue, Clarkston, GA 30021 | 2006-04-10 |
| 1831514538 | Caudelle & Wilson Eye Care LLC | Optometrist | 320 N Jeff Davis Drive, Suite A, Fayetteville, GA 30021 | 2014-03-04 |
| 1881865624 | Vanessa Phan | Dentist | 3596 Hill Street, Clarkston, GA 30021 | 2008-03-20 |
| Find all providers in zip 30021 | ||||
| Taxonomy Code | 286500000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| A health care facility operated by the Department of Defense. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154241 | Department of Veteran Affairs | Military Hospital | 1122 Providence Way, Lawrenceville, GA 30046-3316 | 2016-10-11 |
| 1417307190 | Sanghyub Lee | Military Hospital | 411 E 9th St # 74, Fort Stewart, GA 31314-5036 | 2016-06-14 |
| 1770956252 | Clara Mccomb | Military Hospital | 6600 Van Aalst Blvd., Fort Benning, GA 31905 | 2015-11-05 |
| 1790113348 | Veronica Garrett | Military Hospital | 804 Rosemont Pkwy, Roswell, GA 30076-4934 | 2013-10-17 |
| 1780942664 | Martin Army Community Hospital | Military Hospital | 8830 Watkins Ave, Fort Benning, GA 31905-5529 | 2012-04-27 |
| 1629357934 | United States Army | Military Hospital | 300 W Hospital Rd Rm 7a-46, Fort Gordon, GA 30905-5741 | 2011-08-04 |
| 1093947780 | Army | Military Hospital | 202 Vineyard Way, Apt. 601, Evans, GA 30809 | 2009-08-14 |
| 1609806504 | Va Medical Center | Military Hospital | 940 Capella Creek Way, Grayson, GA 30017-1578 | 2006-07-04 |
| 1508312711 | Martin Army Community Hospital | Military Hospital | Martin Army Community Hospital, 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2016-08-28 |
| 1508312869 | Debbie Speed-simmons | Military Hospital | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2016-08-28 |
| Find all providers with the same taxonomy | ||||
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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.