DURHAM VA MEDICAL CENTER (NPI# 1407028400) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407028400 |
| Entity Type | Organization |
| Organization Name | DURHAM VA MEDICAL CENTER |
| Practice Address |
508 Fulton St Durham NC 27705-3875 |
| Mailing Address |
228 Standish Dr Chapel Hill NC 27517-5553 |
| Practice Telephone | 9192860411 |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |
| Authorized Official Name | MS. DARIA D. LEWIS (SICU STAFF NURSE) |
| Authorized Official Telephone | 9192860411 |
| Authorized Official Credential | RN, BSN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 286500000X | Military Hospital | 186904 | NC | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518127026 | Durham Va Medical Center | General Acute Care Hospital | 508 Fulton St, Durham, NC 27705-3875 | 2008-06-10 |
| 1891754636 | Durham Va Medical Center | General Acute Care Hospital | 508 Fulton St, Durham, NC 27705-3875 | 2006-03-21 |
| 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 |
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| 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 |
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| Taxonomy Code | 286500000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| A health care facility operated by the Department of Defense. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811194731 | Department of Veterans Affairs Medical Center | Military Hospital | 508 Fulton St # 117c, Va Medical Center Mrs. Demetri, Durham, NC 27705-3875 | 2007-07-03 |
| 1508886516 | Detlev Erdmann | Military Hospital | Baker House Duke Rm 131, Duke Uuniversity Medical Center, Durham, NC 27710-0001 | 2006-07-20 |
| 1699173211 | Annie Jayanth | Military Hospital | 508 Fulton St, Durham, NC 27705-3875 | 2014-12-12 |
| 1720251275 | Durham Vamc | Military Hospital | Duke University Medical Center, Erwin Rd, Durham, NC 27710-0001 | 2008-04-04 |
| 1063597193 | Edward Everett Anderson | Military Hospital | 508 Fulton St, Durham, NC 27705-3875 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861867293 | Womack Army Medical Center | Military Hospital | 2817 Reily Road, Fort Bragg, NC 28317 | 2015-12-10 |
| 1083777460 | Tyler Vachon | Military Hospital | Mcas Nr Mag 29 Gas, As 100, Jacksonville, NC 28545-1034 | 2006-12-18 |
| 1275198848 | Louis Perez | Military Hospital | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2019-05-08 |
| 1194246256 | Laura Orlando | Military Hospital | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2017-06-29 |
| 1376091611 | W.g. Bill Hefner Vamc | Military Hospital | 1601 Brenner Ave, Salisbury, NC 28144-2515 | 2016-09-15 |
| 1205293958 | Jennifer E Porter | Military Hospital | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2016-01-26 |
| 1235594094 | Brittany A Lovett | Military Hospital | 2817 Reilly Road, Fort Bragg, NC 28310 | 2015-12-22 |
| 1871977074 | Us Department of Veterans Affairs | Military Hospital | 3040 Hammond Business Pl, Suite 105, Raleigh, NC 27603-3666 | 2015-07-17 |
| 1932451689 | Michelle Tomasa Roper | Military Hospital | 100 Brewster Blvd, Camp Lejeune, NC 28547-2575 | 2012-10-04 |
| 1134425747 | Serena M Leung | Military Hospital | 100 Brewster Blvd, Building 15, Camp Lejeune, NC 28547-2538 | 2011-01-28 |
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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.