DETROIT VAMC (NPI# 1366491136) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366491136 |
| Entity Type | Organization |
| Organization Name | DETROIT VAMC |
| Practice Address |
4646 John R St Detroit MI 48201-1916 |
| Mailing Address |
Po Box 5426 Madison WI 53705-0426 |
| Practice Telephone | 6088217200 |
| Mailing Telephone | 6088217200 |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2017-03-01 |
| 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 | 282N00000X | General Acute Care Hospital | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497143374 | Detroit Vamc | Clinic/Center | 301 Piquette Street, Detroit, MI 48202-3513 | 2014-12-31 |
| 1154781615 | Detroit Vamc | Psychiatric Residential Treatment Facility | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2016-02-26 |
| 1922048750 | Detroit Vamc | Clinic/Center | 7470 Brockway Rd, Brockway, MI 48097-3458 | 2006-06-08 |
| 1609815034 | Detroit Vamc | Clinic/Center | 44200 Woodward Ave, Suite 208, Pontiac, MI 48341-5045 | 2006-06-04 |
| 1184682007 | Detroit Vamc | Department of Veterans Affairs (VA) Pharmacy | 4646 John R St, Detroit, MI 48201-1916 | 2006-05-02 |
| Street Address |
4646 JOHN R ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-1916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356344121 | Christopher Emil Hermann | Nurse Practitioner | 4646 John R St, Detroit, MI 48201-1916 | 2005-05-24 |
| 1881293892 | Derrick Williams | Registered Nurse | 4646 John R St, Detroit, MI 48201-1916 | 2020-10-21 |
| 1598371544 | Sonia Govil | Dietitian, Registered | 4646 John R St, Detroit, MI 48201-1916 | 2020-09-16 |
| 1740893569 | Nicholas Edward Peters | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-31 |
| 1710597455 | Amber Michelle Young | Social Worker | 4646 John R St, Detroit, MI 48201-1916 | 2020-08-07 |
| 1104434471 | Zeinab H Moussa | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-22 |
| 1235747346 | Samantha Beth Lewis | Psychologist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-15 |
| 1477171189 | Rima Mohammad Fardos | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-09 |
| 1992323869 | Sarah F Waqhar | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-08 |
| 1619594181 | Mellisa Ann Boyle | Student in an Organized Health Care Education/Training Program | 4646 John R St, Detroit, MI 48201-1916 | 2020-07-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
| Find all providers in zip 48201 | ||||
| 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 |
|---|---|---|---|---|
| 1740899194 | Ascension Michigan Employer Solutions LLC | General Acute Care Hospital | 5555 Conner St Ste 2818, Detroit, MI 48213-3448 | 2020-07-30 |
| 1043551146 | Detroit Medical Center | General Acute Care Hospital | 3990 John R Rd, Detroit, MI 48201 | 2013-03-14 |
| 1346511151 | Sara Goldgraben | General Acute Care Hospital | 540 E. Canfield, Department of Radiation Oncology, Detroit, MI 48201 | 2012-01-25 |
| 1174837686 | Detroit Medical Center | General Acute Care Hospital | 4201 St. Antoine- 6g Uhc, 6g Uhc, Detroit, MI 48201 | 2010-07-27 |
| 1922239920 | Wayne State University/detroit Medical Center | General Acute Care Hospital | 4201 Saint Antoine St # 2e, Detroit, MI 48201-2153 | 2009-08-07 |
| 1710134010 | Tetsuhiro Higashida | General Acute Care Hospital | 4201 St. Antoine Suite 6e, Detroit, MI 48201 | 2008-08-19 |
| 1487792818 | Detroit Hope Hospital | General Acute Care Hospital | 801 Virgina Park, Detroit, MI 48202 | 2007-02-01 |
| 1134266687 | Detroit Hope Hospital | General Acute Care Hospital | 801 Virginia Park, Detroit, MI 48202 | 2007-01-31 |
| 1669400305 | Ltac Hospital Detroit, LLC | General Acute Care Hospital | 801 Virginia Park St, Third Floor, Detroit, MI 48202-1925 | 2006-06-29 |
| 1043755788 | Barbara Ann Karmanos Cancer Center | General Acute Care Hospital | 4100 John R St, Detroit, MI 48201-2013 | 2017-01-05 |
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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.