VA MEDICAL CENTER (NPI# 1306940879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306940879 |
| Entity Type | Organization |
| Organization Name | VA MEDICAL CENTER |
| Practice Address |
1 Freedom Way Augusta GA 30904-6258 |
| Mailing Address |
402 Brandywine Dr Evans GA 30809-7032 |
| Practice Telephone | 7067330188 |
| Mailing Telephone | 7066501044 |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2009-01-29 |
| Authorized Official Name | MR. GLEN A. WINDLEY (SOCIAL WORKER) |
| Authorized Official Telephone | 7067330188 |
| Authorized Official Credential | MSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 283Q00000X | Psychiatric Hospital | CSW003441 | GA | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245785179 | Va Medical Center | Military Hospital | 5939 Cedros Ave Apt A, Van Nuys, CA 91411-3104 | 2016-08-21 |
| 1104216332 | Va Medical Center | Military Hospital | 10707 W Interstate 10 Apt 436, San Antonio, TX 78230-1674 | 2015-01-26 |
| 1295178796 | Va Medical Center | Military Hospital | 16 Charles St, 3rd Floor, Lincoln, RI 02865-1906 | 2013-04-15 |
| 1487905311 | Va Medical Center | General Acute Care Hospital | 292 Sherwood Dr, Huntington, WV 25704-9460 | 2012-10-02 |
| 1033479316 | Va Medical Center | Chronic Disease Hospital | 500 Trinity Ln N Apt 5204, St Petersburg, FL 33716-1236 | 2012-05-21 |
| 1134495682 | Va Medical Center | General Acute Care Hospital | 5015 S Desoto Ct, New Berlin, WI 53151-7664 | 2012-03-29 |
| 1386952893 | Va Medical Center | General Acute Care Hospital | 6208 Krandon Drive, Raleigh, NC 27603-4928 | 2010-09-17 |
| 1093049520 | Va Medical Center | Military Hospital | 5416 Orange Valley Dr, Lakeland, FL 33813-2649 | 2009-09-30 |
| 1275784050 | Va Medical Center | Skilled Nursing Facility | 236 Pochin Pl, Hampton, VA 23661-2902 | 2008-10-10 |
| 1154587475 | Va Medical Center | General Acute Care Hospital | 4001 24th Ave W, Seattle, WA 98199-1505 | 2008-08-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VA MEDICAL CENTER | 4101 Woolworth Ave, Omaha, NE 68105-1850 |
| System for Award Management (SAM) Entities | VA MEDICAL CENTER 581/90C | 1540 Spring Valley Dr, Huntington, WV 25704-9300 |
| Street Address |
1 FREEDOM WAY |
| City | AUGUSTA |
| State | GA |
| Zip Code | 30904-6258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912900713 | Robert Leon Longe | Pharmacist | 1 Freedom Way, Augusta, GA 30904-6258 | 2005-05-24 |
| 1609476951 | Melissa Ann Cotton | Dentist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-27 |
| 1487253217 | Kelsey Shull | Recreation Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-22 |
| 1437758844 | Angela Marie Brown | Social Worker | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-19 |
| 1538767819 | Stephen William Montgomery | Music Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-09 |
| 1134726631 | Rebecca Leigh Halioua | Recreation Therapist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-10-07 |
| 1104435718 | Vincent Michael Fitch | Psychologist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-07-29 |
| 1558988162 | Amanda Draheim | Psychologist | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-30 |
| 1174140784 | Tiffany Ariel Graves | Student in an Organized Health Care Education/Training Program | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-30 |
| 1982221776 | Janice J Anglin | Dietitian, Registered | 1 Freedom Way, Augusta, GA 30904-6258 | 2020-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518423706 | Lawren Murray Tachias | Registered Nurse | 950 15th Street Downtown, Augusta, GA 30904 | 2019-02-13 |
| 1457851842 | Heba Ahmed | Pharmacist | 912 15th Street, Augusta, GA 30904 | 2018-02-13 |
| 1124552690 | Jenny Liles | Student in an Organized Health Care Education/Training Program | 1004 Chafee Ave, Augusta, GA 30904 | 2017-04-11 |
| 1932640836 | Claudia Crawford | Student in an Organized Health Care Education/Training Program | 2624 Oakland Ave., Augusta, GA 30904 | 2017-03-13 |
| 1801240528 | F. Marion Durst IIi Dmd PC | Clinic/Center | 2325 Washington Road, Augusta, GA 30904 | 2016-04-19 |
| 1689031296 | Teresa Maria Martin | Counselor | 1e-148, Charlie Norwood Vamc One Freedom Way, Augusta, GA 30904 | 2016-01-27 |
| 1598122269 | Jillian Wilkerson | Counselor | Charlie Norwood Veteran Affairs One Freedom Way, Substance Use Recovery Clinic, Augusta, GA 30904 | 2016-01-26 |
| 1760855241 | Chase King | Occupational Therapist | 1735 Berkeley Rd, Augusta, GA 30904 | 2015-11-05 |
| 1962832246 | April Underwood Fox | Physician Assistant | 1417 Pendleton Rd, Augusta, GA 30904 | 2013-11-22 |
| 1861734378 | John Graham Theisen | Obstetrics & Gynecology | 810 Chafee Avenue, Augusta, GA 30904 | 2013-03-22 |
| Find all providers in zip 30904 | ||||
| Taxonomy Code | 283Q00000X |
| Grouping | Hospitals |
| Classification | Psychiatric Hospital |
| An organization including a physical plant and personnel that provides multidisciplinary diagnostic and treatment mental health services to patients requiring the safety, security, and shelter of the inpatient or partial hospitalization settings. |
| Notes: Source: Expanded from Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053319566 | State of Maine | Psychiatric Hospital | 250 Arsenal St, Augusta, ME 04333-0011 | 2005-07-08 |
| 1093046005 | Department of Behavioral Health and Developmental Disabilities | Psychiatric Hospital | 3405 Mike Padgett Hwy, Augusta, GA 30906-3815 | 2010-01-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922485804 | Mildred Grant | Psychiatric Hospital | 255 Sumner Lakes Rd, Sumner, GA 31789-4431 | 2015-04-30 |
| 1013259035 | Janet Warrington | Psychiatric Hospital | 438 Clem Lowell Rd, Carrollton, GA 30116-9255 | 2013-03-18 |
| 1093088643 | Ramsay Youth Services of Georgia, Inc. | Psychiatric Hospital | 3500 Riverside Dr, Macon, GA 31210-2509 | 2012-02-13 |
| 1518295518 | Reentry Corporation of America | Psychiatric Hospital | 260 Peachtree St, Atlanta, GA 30303-1202 | 2009-12-02 |
| 1427292333 | Uhs of Savannah LLC | Psychiatric Hospital | 633 Stephenson Ave, Savannah, GA 31405-5970 | 2009-04-22 |
| 1770742132 | Riverwoods Behavioral Health, LLC | Psychiatric Hospital | 223 Medical Center Drive, Riverdale, GA 30274 | 2008-06-02 |
| 1306913736 | Uhs of Laurel Heights, Lp | Psychiatric Hospital | 934 Briarcliff Rd Ne, Atlanta, GA 30306-2618 | 2006-11-29 |
| 1285663385 | Georgia Department of Human Resources | Psychiatric Hospital | 705 North Division Street Nw, Building 103 - Clinical Director's Office, Rome, GA 30165-1454 | 2006-07-01 |
| 1336114321 | Talbott Recovery Campus | Psychiatric Hospital | 5355 Hunter Rd, Atlanta, GA 30349-2594 | 2006-02-22 |
| 1205809571 | Turning Point Care Center LLC | Psychiatric Hospital | 3015 Veterans Pkwy S, Moultrie, GA 31788-6705 | 2006-02-08 |
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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.