VETERANS ADMINISTRATION MEDICAL CENTER (NPI# 1669579025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669579025 |
| Entity Type | Organization |
| Organization Name | VETERANS ADMINISTRATION MEDICAL CENTER |
| Practice Address |
29431 Charlotte Hall Road Vamc Clinic Charlotte Hall MD 20622 |
| Mailing Address |
Po Box 296 Clinton MD 20735 |
| Practice Telephone | 3018847102 |
| Mailing Telephone | 3019967709 |
| Mailing Fax Number | 3018847106 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. VERONICA DENISE RANDOLPH (ADULT NURSE PRACTITIONER) |
| Authorized Official Telephone | 3018847902 |
| Authorized Official Credential | NURSE PRACTITION |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | R110705 | MD | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790192631 | Veterans Administration Medical Center | General Acute Care Hospital | 863 Rambling Oaks Dr, Norman, OK 73072-4186 | 2014-07-11 |
| 1528239621 | Veterans Administration Medical Center | Psychiatric Unit | 2 Heathman Road, White Hall, Rm 309, Kingston, RI 02881 | 2008-03-17 |
| 1861815201 | Veterans Administration Medical Center | Military Hospital | 7305 N Military Trl, Riviera Beach, FL 33410-7417 | 2014-01-21 |
| 1275808321 | Veterans Administration Medical Center | Military Hospital | 100 Emancipation Dr, Hampton, VA 23667-0001 | 2012-03-21 |
| 1205144730 | Veterans Administration Medical Center | General Acute Care Hospital | 1100 Tunnel Rd, Asheville, NC 28805-2576 | 2010-09-17 |
| 1366694465 | Veterans Administration Medical Center | General Acute Care Hospital | 1901 S 1st St, Temple, TX 76504-7451 | 2008-10-21 |
| 1134329451 | Veterans Administration Medical Center | Clinic/Center | 2495 Shreveport Hwy, Pineville, LA 71360-4044 | 2007-07-24 |
| 1275748006 | Veterans Administration Medical Center | Special Hospital | 601 Highway 6 W, Iowa City, IA 52246-2292 | 2007-05-14 |
| 1861576183 | Veterans Administration Medical Center | General Acute Care Hospital | 2495 Shreveport Hwy, Pineville, LA 71360-4044 | 2006-10-24 |
| 1043393242 | Veterans Administration Medical Center | Counselor | 1100 N College Ave, Fayetteville, AR 72703-1944 | 2006-10-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VETERANS ADMINISTRATION MEDICAL CENTER | 500 W Fort St., Boise, ID 83702-4501 |
| Street Address |
29431 CHARLOTTE HALL ROAD VAMC CLINIC |
| City | CHARLOTTE HALL |
| State | MD |
| Zip Code | 20622 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164075917 | Academy Dental Care LLC | Dentist | 37601 Golden Beach Rd., Charlotte Hall, MD 20622 | 2019-07-22 |
| 1215405824 | Erin Elizabeth Wilkins | Counselor | 30007 Business Center Drive, Charlotte Hall, MD 20622 | 2018-11-13 |
| 1073913646 | Michelle Northam | Counselor | 29958 Killpeck Creek Ct, Charlotte Hall, MD 20622 | 2014-09-02 |
| 1326380486 | Kaveh Zakeri | Radiology | 30077 Business Center Dr, Charlotte Hall, MD 20622 | 2013-03-26 |
| 1235481672 | Dana Kim | Dentist | 29795 Three Notch Rd., Charlotte Hall, MD 20622 | 2012-10-09 |
| 1376714121 | Pediatric Dentistry of Southern Maryland | Dentist | 29795 Three Notch Road, Charlotte Hall, MD 20622 | 2008-03-20 |
| 1407054349 | Shah Associates Md LLC | Internal Medicine | Charlotte Hall Medical Center, 37767 Market Dr. 2nd Floor, Charlotte Hall, MD 20622 | 2007-07-03 |
| 1124245329 | Board of Child Care of The United Methodist Church Inc | Community/Behavioral Health | 30049 Business Center Drive, Charlotte Hall, MD 20622 | 2007-04-19 |
| 1700977345 | Laura R Starks | Physical Therapist | 29770 Three Notch Road, Charlotte Hall, MD 20622 | 2006-09-27 |
| 1659462133 | Coordinated Movements Inc | Physical Therapist | 29770 Three Notch Road Suite 201, Charlotte Hall, MD 20622 | 2006-09-27 |
| Find all providers in zip 20622 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1093328148 | Cerner Health Connections, Inc | Clinic/Center | 15045 Burnt Store Rd, Hughesville, MD 20637-2699 | 2020-08-28 |
| 1750991121 | Global Center for Autism Services, LLC | Clinic/Center | 4485 Forbes Blvd, Lanham, MD 20706-4354 | 2020-07-31 |
| 1497384945 | Unique Minds Behavioral Health Services, LLC | Clinic/Center | 8101 Sandy Spring Rd Ste 300-e6, Laurel, MD 20707-3596 | 2020-04-06 |
| 1215565957 | Red Canyon, LLC | Clinic/Center | 7402 York Rd Ste 104, Towson, MD 21204-7519 | 2020-03-30 |
| 1215560396 | Bridge To Holistic Healing, LLC | Clinic/Center | 223 N Prospect St Ste 306, Hagerstown, MD 21740-3783 | 2020-02-18 |
| Find all providers with the same taxonomy | ||||
| City | CHARLOTTE HALL |
| Zip Code | 20622 |
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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.