JACKSON VAMC (NPI# 1043250418) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1043250418 |
Entity Type | Organization |
Organization Name | JACKSON VAMC |
Other Organization Name | GREENVILLE VA CBOC |
Practice Address |
1502 S Colorado St Greenville MS 38703-7219 |
Mailing Address |
Po Box 94497 Cleveland OH 44101-4497 |
Practice Telephone | 6153553451 |
Mailing Telephone | 6153553451 |
Enumeration Date | 2006-06-07 |
Last Update Date | 2017-10-04 |
Authorized Official Name | MRS. 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 |
---|---|
Greenville VA CBOC | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407303050 | Jackson Vamc | Clinic/Center | 6522 Dogwood View Parkway, Suite F, Jackson, MS 39213-7858 | 2016-09-01 |
1841232097 | Jackson Vamc | Clinic/Center | 405 W Adams St, Kosciusko, MS 39090-3617 | 2006-06-12 |
1669410288 | Jackson Vamc | Clinic/Center | 2103 13th St, Meridian, MS 39301-4045 | 2006-06-04 |
1528006152 | Jackson Vamc | Clinic/Center | 105 Northgate Rd, Suite 2, Natchez, MS 39120-9162 | 2006-06-04 |
1376598698 | Jackson Vamc | Clinic/Center | 5003 Hardy Street, Tower B Suite 402, Hattiesburg, MS 39402-1331 | 2006-05-24 |
1295787364 | Jackson Vamc | Clinic/Center | 824 Alabama St, Columbus, MS 39702-5436 | 2006-05-17 |
1154784965 | Jackson Vamc | Psychiatric Residential Treatment Facility | 1500 Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2016-03-30 |
1922496280 | Jackson Vamc | Clinic/Center | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2015-01-08 |
1467762120 | Jackson Vamc | Clinic/Center | 1308 Harrison Ave, Mccomb, MS 39648-2830 | 2010-10-15 |
1992754543 | Jackson Vamc | General Acute Care Hospital | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2006-05-10 |
Street Address |
1502 S COLORADO ST |
City | GREENVILLE |
State | MS |
Zip Code | 38703-7219 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1376196238 | Willie Andrew Pole Jr. | Social Worker | 1502 S Colorado St, Greenville, MS 38703-7219 | 2019-07-19 |
1194211094 | Carly Maranne Hazzard | Nurse Practitioner | 1502 S Colorado St, Greenville, MS 38703-7219 | 2018-07-03 |
1992241269 | Medical Foundation of Central Ms Inc | Internal Medicine | 1502 S Colorado St, Greenville, MS 38703-7219 | 2017-01-11 |
1578016259 | Medical Foundation of Central Ms Inc | Internal Medicine | 1502 S Colorado St, Greenville, MS 38703-7219 | 2016-07-28 |
1861843690 | Patricia Ann Barber | Nurse Practitioner | 1502 S Colorado St, Greenville, MS 38703-7219 | 2016-06-22 |
1568848299 | Mary Riley | Nurse Practitioner | 1502 S Colorado St, Greenville, MS 38703-7219 | 2015-08-04 |
1144620592 | Kelli Bearden | Nurse Practitioner | 1502 S Colorado St, Greenville, MS 38703-7219 | 2014-09-03 |
1457798241 | Greenville Neuro Diagnostic Center, P.C. | Psychiatry & Neurology | 1502 S Colorado St, Greenville, MS 38703-7219 | 2013-06-03 |
1730446303 | Greenville Neurology Center, LLC | Psychiatry & Neurology | 1502 S Colorado St, Greenville, MS 38703-7219 | 2012-04-19 |
1164654471 | Rheumatology Associates of Greenville PC | Clinic/Center | 1502 S Colorado St, Greenville, MS 38703-7219 | 2009-08-20 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164031373 | Rohith Reddy Guduru Venkata | Family Medicine | Delta Regional Medical Center, 1400 E Union St, Greenville, MS 38703 | 2020-07-24 |
1720627599 | Ava Seniors Academy LLC | Clinic/Center | 2425 E. Alexander Street, Greenville, MS 38703 | 2019-12-27 |
1902370661 | River City Rehabilitation | Physical Therapy Assistant | 1707 South Colorado Suite A, Greenville, MS 38703 | 2019-01-16 |
1942743653 | Jalisa R Greer | Speech-Language Pathologist | 1462 S Colorado Street, Apt 2g, Greenville, MS 38703 | 2016-11-29 |
1912381609 | Mvp Health Systems | Pharmacy | 1907 N. Medical Park Drive, Greenville, MS 38703 | 2015-07-13 |
1558704387 | Joann Wilson | Driver | 1766 Old Leland Rd, Greenville, MS 38703 | 2013-04-11 |
1215167150 | Luther Brandon Oakes | Family Medicine | 1907 Lisa Drive Ext, Greenville, MS 38703 | 2009-07-24 |
1346462751 | Drs Lenoir and Cirilli Pa | Internal Medicine | 1307 East Union, Greenville, MS 38703 | 2007-05-03 |
1669598561 | Michael Joseph Cirilli | Internal Medicine | 1307 E Union, Doctors Lenoir & Cirilli Pa, Greenville, MS 38703 | 2007-03-22 |
1780740183 | Jean Marie Barker | Family Medicine | 1659 East Union Street, Greenville, MS 38703 | 2006-12-29 |
Find all providers in zip 38703 |
Taxonomy Code | 261QV0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | VA |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1811942121 | Dallas Vamc | Clinic/Center | 4006 Wellington St, Greenville, TX 75401-7828 | 2006-05-24 |
1174614531 | Dept of Veterans Affairs | Clinic/Center | 3510 Augusta Rd, Greenville, SC 29605-1302 | 2006-09-28 |
1104865211 | Columbia Vamc | Clinic/Center | 41 Park Creek Dr, Greenville, SC 29605-4270 | 2006-06-05 |
1083669030 | Durham Vamc | Clinic/Center | 401 Moye Blvd, Greenville, NC 27834-2885 | 2006-05-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1407303050 | Jackson Vamc | Clinic/Center | 6522 Dogwood View Parkway, Suite F, Jackson, MS 39213-7858 | 2016-09-01 |
1841232097 | Jackson Vamc | Clinic/Center | 405 W Adams St, Kosciusko, MS 39090-3617 | 2006-06-12 |
1669410288 | Jackson Vamc | Clinic/Center | 2103 13th St, Meridian, MS 39301-4045 | 2006-06-04 |
1528006152 | Jackson Vamc | Clinic/Center | 105 Northgate Rd, Suite 2, Natchez, MS 39120-9162 | 2006-06-04 |
1073552436 | Memphis Vamc | Clinic/Center | 1114 Commonwealth Blvd., Tupelo, MS 38804-9998 | 2006-06-04 |
1376598698 | Jackson Vamc | Clinic/Center | 5003 Hardy Street, Tower B Suite 402, Hattiesburg, MS 39402-1331 | 2006-05-24 |
1194778357 | Memphis Vamc | Clinic/Center | 1700 Crescent Meadows, Holly Springs, MS 38635-7414 | 2006-05-18 |
1295787364 | Jackson Vamc | Clinic/Center | 824 Alabama St, Columbus, MS 39702-5436 | 2006-05-17 |
1972044048 | Dewona Flowers | Clinic/Center | 604 Lexington Cv, Byram, MS 39272-3004 | 2017-03-09 |
1245770445 | Clinton Medical Center | Clinic/Center | 604 Lexington Cv, Byram, MS 39272-3004 | 2017-03-07 |
Find all providers with the same taxonomy |
City | GREENVILLE |
Zip Code | 38703 |
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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.