OVERTON BROOKS VAMC (NPI# 1568822658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568822658 |
| Entity Type | Organization |
| Organization Name | OVERTON BROOKS VAMC |
| Practice Address |
200 Hartwell Rd Minden LA 71055-6365 |
| Mailing Address |
200 Hartwell Road Minden LA 71055 |
| Practice Telephone | 3187075088 |
| Mailing Telephone | 3187075088 |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2016-03-02 |
| Authorized Official Name | MRS. LAKISHIA LEWIS GRIDER (ACUTE CARE NURSE PRACTITIONER) |
| Authorized Official Telephone | 3182218411 |
| Authorized Official Credential | N.P. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2865M2000X |
Military Hospital Specialization: Military General Acute Care Hospital |
006290999 | LA | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285925982 | Overton Brooks Vamc | Clinic/Center | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2011-04-28 |
| 1295974574 | Overton Brooks Vamc | General Acute Care Hospital | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2009-02-11 |
| 1396774451 | Overton Brooks Vamc | General Acute Care Hospital | 510 E Stoner Ave, 117, Shreveport, LA 71101-4243 | 2006-07-01 |
| Street Address |
200 HARTWELL RD |
| City | MINDEN |
| State | LA |
| Zip Code | 71055-6365 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053911339 | Walter Matheny II | Nurse Practitioner | 216 W Union Street Ste A Minden, Minden, LA 71055 | 2020-10-27 |
| 1194331579 | Minden Family Pharmacy LLC | Pharmacy | 120 Homer Rd, Minden, LA 71055 | 2020-09-21 |
| 1003469479 | Premier Family Clinic | Nurse Practitioner | 102 Office Park Dr., Minden, LA 71055 | 2019-07-24 |
| 1952803389 | Regina Flournoy | Case Manager/Care Coordinator | 561 Angi Rd, Minden, LA 71055 | 2018-03-01 |
| 1902322233 | New Concept Development Center | Clinic/Center | 15365 Hwy 80, Minden, LA 71055 | 2017-08-18 |
| 1396269304 | Tashalana Walker | Counselor | 601 Homer Rd., Minden, LA 71055 | 2017-08-01 |
| 1992227029 | Kathryn Anne Landreneau | Nurse Practitioner | 101 Murrell St Ste 2, Minden, LA 71055 | 2017-07-11 |
| 1639699937 | Shykiia Hawkins | Counselor | 409 Meadowview Drive, Minden, LA 71055 | 2017-06-27 |
| 1053851147 | Shatoria Moore | Case Manager/Care Coordinator | 305 Homer Rd, Minden, LA 71055 | 2017-03-08 |
| 1821547258 | Sheretha Harrison | Counselor | 1008 Brenda Cir, Minden, LA 71055 | 2016-09-27 |
| Find all providers in zip 71055 | ||||
| Taxonomy Code | 2865M2000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| Specialization | Military General Acute Care Hospital |
| A Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in "fixed" facilities, primarily for DoD beneficiaries. Entity is Defense Health Program (DHP) funded. A "fixed" facility is a non-temporary, non-deployed facility usually used for health care services. It includes mobile specialty units such as Magnetic Resonance Imaging (MRI) units that may furnish services at the "fixed" facility. It includes those services and institutional costs usually included in a Diagnosis Related Group as well as "pass-through" items. |
| Notes: [1/1/2005: title modified, definition added] |
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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.