MEMPHIS VAMC (NPI# 1619923398) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619923398 |
Entity Type | Organization |
Organization Name | MEMPHIS VAMC |
Other Organization Name | JONESBORO VA CBOC |
Practice Address |
2908 S Caraway Rd Ste B Jonesboro AR 72401-7306 |
Mailing Address |
Po Box 94511 Cleveland OH 44101 |
Practice Telephone | 6153553451 |
Mailing Telephone | 6153553451 |
Enumeration Date | 2006-05-25 |
Last Update Date | 2020-02-04 |
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 |
---|---|
Jonesboro VA CBOC | Other Name - Individual/Organization |
JONESBORO VA CLINIC | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1649401316 | Memphis Vamc | Clinic/Center | 125 Quarles Ln, West Helena, AR 72390-1923 | 2009-07-29 |
1205072436 | Memphis Vamc | Clinic/Center | 180 Old Hickory Blvd, Suite A, Jackson, TN 38305-2562 | 2008-12-17 |
1073552436 | Memphis Vamc | Clinic/Center | 1114 Commonwealth Blvd., Tupelo, MS 38804-9998 | 2006-06-04 |
1669427050 | Memphis Vamc | Clinic/Center | 70 Harbert Dr, Savannah, TN 38372-2333 | 2006-05-23 |
1194778357 | Memphis Vamc | Clinic/Center | 1700 Crescent Meadows, Holly Springs, MS 38635-7414 | 2006-05-18 |
1154374726 | Memphis Vamc | Clinic/Center | 3461 Austin Peay Hwy, Memphis, TN 38128-3801 | 2006-05-17 |
1326436452 | Memphis Vamc | Clinic/Center | 1407 Union Ave, 11th Floor, Memphis, TN 38104-3627 | 2014-12-23 |
1659667996 | Memphis Vamc | Military Hospital | 1030 Jefferson Ave, Memphis, TN 38104-2127 | 2011-06-24 |
1356572010 | Memphis Vamc | Clinic/Center | 1067 Vendall Rd, Dyersburg, TN 38024-1622 | 2009-07-29 |
1134370885 | Memphis Vamc | Clinic/Center | 154 Mt. Pleasant Road, Mount Pleasant, MS 38635-9332 | 2008-09-30 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | MEMPHIS VAMC | 1030 Jefferson Ave, Memphis, TN 38104-2127 |
Street Address |
2908 S CARAWAY RD STE B |
City | JONESBORO |
State | AR |
Zip Code | 72401-7306 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407453368 | Mariah Kay Jackson | Physical Therapy Assistant | Creative Kids Therapy, Jonesboro, AR 72401 | 2020-10-05 |
1821606005 | Kafayat Folake Iyanda | Specialist/Technologist | 2105 East Aggie Rd, Jonesboro, AR 72401 | 2020-07-14 |
1053936310 | Josh Roberts | Physical Therapist | 1010 South Main St, Jonesboro, AR 72401 | 2020-06-12 |
1003449687 | Amy Mary Elizabeth Daughhetee | Nurse Practitioner | 225 East Washington Ave, Jonesboro, AR 72401 | 2020-02-21 |
1871126698 | Sarah Lowtharp | Clinical Nurse Specialist | 225 East Washington Ave., Jonesboro, AR 72401 | 2020-02-20 |
1891335519 | Mallori Miller | Case Manager/Care Coordinator | 837 Willett Rd, Jonesboro, AR 72401 | 2020-01-10 |
1265073704 | Michael Bruce Collie | Registered Nurse | 837 Williett Road, Jonesboro, AR 72401 | 2019-10-07 |
1285283432 | Jonesboro Ambulatory Surgery Center, LLC | Clinic/Center | 1710 Mayfield Dr, Jonesboro, AR 72401 | 2019-09-10 |
1841843943 | Destinee Katrina Cole | Specialist/Technologist | 2015 Aggie Rd, Jonesboro, AR 72401 | 2019-07-18 |
1699250472 | Jessica Marie Mcnatt | Occupational Therapist | 907 County Road 753, Jonesboro, AR 72401 | 2018-09-27 |
Find all providers in zip 72401 |
Taxonomy Code | 261QV0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | VA |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528456811 | Fayetteville Vamc | Clinic/Center | 216 East Township Street, Fayetteville, AR 72703-2818 | 2015-01-08 |
1073821518 | Little Rock Vamc | Clinic/Center | 1520 E Dave Ward Dr, Conway, AR 72032-9649 | 2010-09-17 |
1831415751 | Fayetteville Vamc | Clinic/Center | 2713 W Commercial St, Ozark, AR 72949-3409 | 2010-04-16 |
1649401316 | Memphis Vamc | Clinic/Center | 125 Quarles Ln, West Helena, AR 72390-1923 | 2009-07-29 |
1508809948 | St. Louis Jc Vamc | Clinic/Center | 2420 Linwood Dr, Suite 3, Paragould, AR 72450-6122 | 2006-06-14 |
1417996489 | Shreveport Vamc | Clinic/Center | 910 Realtor Road, Texarkana, AR 71854-1020 | 2006-06-05 |
1063450617 | Little Rock Vamc | Clinic/Center | 759 Highway 62 E, Suite 331, Mountain Home, AR 72653-3260 | 2006-06-04 |
1861439697 | Little Rock Vamc | Clinic/Center | 300 Morrow St S, Mena, AR 71953 | 2006-06-01 |
1215982582 | Little Rock Vamc | Clinic/Center | 177 Sawtooth Oak St, Hot Springs, AR 71901-7160 | 2006-05-24 |
1215980164 | Little Rock Vamc | Clinic/Center | 1702 N West Ave, El Dorado, AR 71730 | 2006-05-19 |
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.