VA MID-ATLANTIC HEALTHCARE NETWORK (NPI# 1104367010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104367010 |
| Entity Type | Organization |
| Organization Name | VA MID-ATLANTIC HEALTHCARE NETWORK |
| Practice Address |
508 Fulton St Durham NC 27705-3875 |
| Practice Telephone | 9192860411 |
| Practice Fax Number | 9194165938 |
| Mailing Telephone | 9192860411 |
| Mailing Fax Number | 9194165938 |
| Enumeration Date | 2017-03-10 |
| Last Update Date | 2017-03-10 |
| Authorized Official Name | DR. AMY LINDSTROM CLARKE (CLINICAL PHARMACY SPECIALIST) |
| Authorized Official Telephone | 9192860411 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282N00000X | General Acute Care Hospital | 18925 | NC | Hospitals |
| Street Address |
508 FULTON ST |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-3875 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043217086 | Stuart Hall Manning | Internal Medicine | 508 Fulton St, C/o Durham Va Medical Center, Durham, NC 27705-3875 | 2005-07-06 |
| 1245839083 | Jessica Elizabeth Cornett | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
| 1043819808 | Rebecca Parker Maccioli | Recreation Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-22 |
| 1174122055 | Aline Xayasouk | Occupational Therapist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-21 |
| 1730786187 | Kathryn Masincupp | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-10-07 |
| 1700490349 | Sarah Elizabeth Parker | Nurse Practitioner | 508 Fulton St, Durham, NC 27705-3875 | 2020-09-01 |
| 1144833716 | Phillip Charles Tampis | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-24 |
| 1164033445 | Alexandra Demascole | Social Worker | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-11 |
| 1386254498 | Krishna Rana | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
| 1730799842 | Jinah Han | Pharmacist | 508 Fulton St, Durham, NC 27705-3875 | 2020-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| Taxonomy Code | 282N00000X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| An acute general hospital is an institution whose primary function is to provide inpatient diagnostic and therapeutic services for a variety of medical conditions, both surgical and non-surgical, to a wide population group. The hospital treats patients in an acute phase of illness or injury, characterized by a single episode or a fairly short duration, from which the patient returns to his or her normal or previous level of activity. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760925143 | Duke University Medical Center | General Acute Care Hospital | 2543 Meridian Pkwy Apt 2106, Durham, NC 27713-2496 | 2016-12-02 |
| 1487052114 | Hiroshi Okuda | General Acute Care Hospital | 103015 Dumc, Durham, NC 27710-0001 | 2014-12-11 |
| 1053664987 | Duke University | General Acute Care Hospital | 631 Windsong Ln, Durham, NC 27713-9169 | 2012-10-16 |
| 1699065136 | Duke University Hospital | General Acute Care Hospital | 908a Onslow St, Durham, NC 27705-4247 | 2011-04-18 |
| 1487980033 | Veterans Affairs | General Acute Care Hospital | 1426 Ida St Apt J, Durham, NC 27705-3330 | 2009-11-02 |
| 1629205026 | Duke University Health System | General Acute Care Hospital | 307 Trent Drive Dumc # 3322, Durham, NC 27710-0001 | 2009-06-12 |
| 1952540171 | Select Specialty Hospital | General Acute Care Hospital | 3643 North Roxboro Rd, Durham, NC 27704 | 2009-02-11 |
| 1427214246 | Dumc | General Acute Care Hospital | Dumc 3677, Durham, NC 27710-0001 | 2008-07-31 |
| 1265695951 | Duke University Medical Center | General Acute Care Hospital | Duke South Blue Zone Rm 4530, Durham, NC 27710-0001 | 2008-07-03 |
| 1891954806 | Duke Medical Center | General Acute Care Hospital | Erwin St, Durham, NC 27710-0001 | 2008-06-04 |
| Find all providers in DURHAM | ||||
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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.