FAYETTEVILLE VAMC (NPI# 1194256362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194256362 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE VAMC |
| Other Organization Name | FAYETTEVILLE 4 VA CLINIC |
| Practice Address |
4101 Raeford Road Suite 100-b Fayetteville NC 28304-4114 |
| Mailing Address |
Po Box 89494 Cleveland OH 44101-6494 |
| Practice Telephone | 8282572333 |
| Mailing Telephone | 8282572333 |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2018-04-11 |
| 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 |
|---|---|
| FAYETTEVILLE 4 VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992264824 | Fayetteville Vamc | Clinic/Center | 3015 Connecticut Ave, Joplin, MO 64804-3035 | 2019-03-19 |
| 1659879138 | Fayetteville Vamc | Clinic/Center | 4 Josh Ct, Jacksonville, NC 28546-0052 | 2018-01-30 |
| 1528456811 | Fayetteville Vamc | Clinic/Center | 216 East Township Street, Fayetteville, AR 72703-2818 | 2015-01-08 |
| 1124422308 | Fayetteville Vamc | Clinic/Center | 306 Brynn Marr Rd, Jacksonville, NC 28546-7023 | 2014-10-16 |
| 1962819052 | Fayetteville Vamc | Clinic/Center | 18 Doctors Cir Ste 2, Supply, NC 28462-4089 | 2014-07-21 |
| 1114270212 | Fayetteville Vamc | Clinic/Center | 3112 Tramway Road, Sanford, NC 27332-9998 | 2012-10-26 |
| 1912201146 | Fayetteville Vamc | Clinic/Center | 139 Three Hunts Drive, Pembroke, NC 28372-6800 | 2011-01-03 |
| 1831415751 | Fayetteville Vamc | Clinic/Center | 2713 W Commercial St, Ozark, AR 72949-3409 | 2010-04-16 |
| 1568417798 | Fayetteville Vamc | Clinic/Center | 4006 Henderson Drive, Jacksonville, NC 28546-9998 | 2006-05-24 |
| 1538799002 | Fayetteville Vamc | Clinic/Center | 2580 Henderson Dr, Jacksonville, NC 28546-5252 | 2020-01-23 |
| Street Address |
4101 RAEFORD ROAD SUITE 100-B |
| City | FAYETTEVILLE |
| State | NC |
| Zip Code | 28304-4114 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301061 | Coast To Coast Bilingual Counseling | Social Worker | 910 Hope Mills Road, Fayetteville, NC 28304 | 2019-11-20 |
| 1811530561 | Frances L. Hurst | Technician | 6732 Carloway Dr, Fayetteville, NC 28304 | 2019-10-25 |
| 1538717764 | Rose Mary A O'conner | Technician | 3530 Madison Ave, Fayetteville, NC 28304 | 2019-08-30 |
| 1932756087 | Sally Frances Jones | Technician | 2053 Mango Circle, Fayetteville, NC 28304 | 2019-08-23 |
| 1326528803 | Jeneen Yvette Townsend | Counselor | 2671 Adams Lake Dr Apt F, Fayetteville, NC 28304 | 2018-08-15 |
| 1780179580 | Ma Cornelia Villavicencio Leano | Nurse Practitioner | 3081 Stone Carriage Cir Apt Z, Fayetteville, NC 28304 | 2018-06-25 |
| 1861986267 | Pediatric After Hours Care of Fayetteville | Pediatrics | 556 Sandhurst Drive, Fayetteville, NC 28304 | 2018-06-19 |
| 1700386133 | Good Night Medical of Ohio, LLC | Durable Medical Equipment & Medical Supplies | 405 Owen Dr Ste 202, Fayetteville, NC 28304 | 2018-02-12 |
| 1003321365 | Valleygate Dental Surgery Center of Fayetteville, LLC | Dentist | 2038 Litho Place, Fayetteville, NC 28304 | 2017-12-08 |
| 1871004663 | The Salt Project | Marriage & Family Therapist | 1611-b Owen Dr., Fayetteville, NC 28304 | 2017-10-19 |
| Find all providers in zip 28304 | ||||
| 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 |
| 1649721309 | Fayetteville Vamc | Clinic/Center | 2300 Ramsey Street, Fayetteville, NC 28301-3856 | 2016-10-18 |
| 1972974392 | Fayetteville Vamc | Clinic/Center | 7300 S Raeford Rd, Fayetteville, NC 28304-6162 | 2015-10-12 |
| 1437547726 | Fayetteville Vamc | Clinic/Center | 180 E Sunbridge Dr, Fayetteville, AR 72703-2830 | 2015-01-08 |
| 1457759615 | Fayetteville Vamc | Clinic/Center | 2300 Ramsey St, Fayetteville, NC 28301-3856 | 2014-12-19 |
| 1801294145 | Fayetteville Vamc | Clinic/Center | 2301 Robeson St, Fayetteville, NC 28305-5640 | 2014-12-19 |
| 1134473440 | Fayetteville Vamc | Clinic/Center | 1100 N College Ave, Fayetteville, AR 72703-1944 | 2012-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003446105 | Durham Vamc | Clinic/Center | 11618 Us 70 Business Highway West, Suites 100 and 200, Clayton, NC 27520-2275 | 2020-01-17 |
| 1659879138 | Fayetteville Vamc | Clinic/Center | 4 Josh Ct, Jacksonville, NC 28546-0052 | 2018-01-30 |
| 1457719312 | Salisbury Vamc | Clinic/Center | 3506 W Tyvola Road, Charlotte, NC 28208-9998 | 2016-02-08 |
| 1609274943 | Durham Vamc | Clinic/Center | 8081 Arco Corporate Dr, Suite 103, Raleigh, NC 27617-2041 | 2014-12-19 |
| 1124422308 | Fayetteville Vamc | Clinic/Center | 306 Brynn Marr Rd, Jacksonville, NC 28546-7023 | 2014-10-16 |
| 1962819052 | Fayetteville Vamc | Clinic/Center | 18 Doctors Cir Ste 2, Supply, NC 28462-4089 | 2014-07-21 |
| 1114270212 | Fayetteville Vamc | Clinic/Center | 3112 Tramway Road, Sanford, NC 27332-9998 | 2012-10-26 |
| 1174800585 | Hampton Vamc | Clinic/Center | 1845 West City Drive, Elizabeth City, NC 27909-9633 | 2011-11-14 |
| 1912201146 | Fayetteville Vamc | Clinic/Center | 139 Three Hunts Drive, Pembroke, NC 28372-6800 | 2011-01-03 |
| 1811225428 | Asheville Vamc | Clinic/Center | 2270 College Ave Ste 145, Forest City, NC 28043-2459 | 2009-11-20 |
| Find all providers with the same taxonomy | ||||
| City | FAYETTEVILLE |
| Zip Code | 28304 |
Please comment or provide details below to improve the information on FAYETTEVILLE VAMC.
| 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.