AUGUSTA VAMC (NPI# 1437547569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437547569 |
| Entity Type | Organization |
| Organization Name | AUGUSTA VAMC |
| Other Organization Name | STATESBORO VA CLINIC |
| Practice Address |
658 Northside Dr E Suite B Statesboro GA 30458-4828 |
| Mailing Address |
Po Box 89454 Cleveland OH 44101-6454 |
| Practice Telephone | 8282572333 |
| Mailing Telephone | 8282572333 |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2018-04-12 |
| 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 |
|---|---|
| STATESBORO VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306014113 | Augusta Vamc | Clinic/Center | 950 Millbrook Ave, Aiken, SC 29803-0602 | 2008-02-14 |
| 1407909799 | Augusta Vamc | Clinic/Center | 9249 Highway 29, Athens, GA 30601-6352 | 2007-01-19 |
| 1649237751 | Augusta Vamc | Department of Veterans Affairs (VA) Pharmacy | 950 15th St, Augusta, GA 30901-2608 | 2006-05-01 |
| 1194783142 | Augusta Vamc | Department of Veterans Affairs (VA) Pharmacy | 1 Freedom Way # 114, Augusta, GA 30904-6258 | 2006-05-01 |
| 1487843744 | Augusta Vamc | Rehabilitation Unit | 1 Freedom Way, Augusta, GA 30904-6258 | 2007-10-23 |
| 1942259924 | Augusta Vamc | General Acute Care Hospital | 1 Freedom Way, Augusta, GA 30904-6258 | 2006-05-08 |
| 1801844469 | Augusta Vamc | General Acute Care Hospital | 950 15th St, Augusta, GA 30901-2608 | 2006-05-05 |
| Street Address |
658 NORTHSIDE DR E SUITE B |
| City | STATESBORO |
| State | GA |
| Zip Code | 30458-4828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780687954 | Henry Kevin Purvis | Family Medicine | 658 Northside Dr E, Ste A, Statesboro, GA 30458-4828 | 2005-05-23 |
| 1437557287 | Shelly Phillips | Nurse Practitioner | 658 Northside Dr E, Suite A, Statesboro, GA 30458-4828 | 2014-12-10 |
| 1457354631 | Hubert Randolph Smith | Family Medicine | 658 Northside Dr E, Suite A, Statesboro, GA 30458-4828 | 2005-05-23 |
| 1851394969 | Carla S. Branch | Family Medicine | 658 Northside Dr E, Ste A, Statesboro, GA 30458-4828 | 2005-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639642218 | Youtherapy | Counselor | 430 Northside Dr East, Suite 160 Mb326, Statesboro, GA 30458 | 2019-01-07 |
| 1053891853 | Alexandria Franklin | Specialist/Technologist | 1332 Southern Dr, Statesboro, GA 30458 | 2018-08-21 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1689186405 | Chandler James Herman | Specialist/Technologist | 590 Herty Dr., Statesboro, GA 30458 | 2017-11-02 |
| 1477009181 | Mama Doc Pediatrics, LLC | Pediatrics | 400 East Grady Street, Statesboro, GA 30458 | 2016-09-01 |
| 1053761171 | Rebekah Roessler | Specialist/Technologist | 2687 Akins Blvd, Statesboro, GA 30458 | 2016-06-20 |
| 1427412253 | Refocus Counseling and Consulting Services | Community/Behavioral Health | 4325 Country Club, 4, Statesboro, GA 30458 | 2016-04-07 |
| 1023408523 | Kacy H. Nesmith | Nurse Practitioner | 1098 Bermuda Run, Suite 6, Statesboro, GA 30458 | 2015-02-04 |
| 1760870398 | Jessica Pasternack | Specialist/Technologist | 2687 Akins Boulevard, Statesboro, GA 30458 | 2015-01-06 |
| 1922401629 | Nathan D'amico | Student in an Organized Health Care Education/Training Program | 15 W Grady Street Unit A, Statesboro, GA 30458 | 2014-10-08 |
| Find all providers in zip 30458 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790333649 | Atlanta Vamc | Clinic/Center | 2309 Parklake Dr Ne, Atlanta, GA 30345-2914 | 2019-09-03 |
| 1962050286 | Atlanta Vamc | Clinic/Center | 934 E Church St, Jasper, GA 30143-1926 | 2019-08-29 |
| 1811545130 | Atlanta Vamc | Clinic/Center | 1800 Phoenix Blvd Ste 100, College Park, GA 30349-6055 | 2019-08-29 |
| 1811551633 | Atlanta Vamc | Clinic/Center | 2217 Roswell Rd Ste 114, Marietta, GA 30062-2957 | 2019-04-26 |
| 1982074720 | Montgomery Vamc | Clinic/Center | 6635 Bass Road, Bldg. 9214, Fort Benning, GA 31905-9998 | 2015-10-06 |
| 1871981084 | Atlanta Vamc | Clinic/Center | 755 Commerce Drive, Suite 700, Decatur, GA 30030-2621 | 2014-12-23 |
| 1174911200 | Atlanta Vamc | Clinic/Center | 1513 Cleveland Avenue, Suite 300, East Point, GA 30344-6951 | 2014-12-23 |
| 1669860888 | Atlanta Vamc | Clinic/Center | 2296 Henderson Mill Rd Ne Ste 402, Atlanta, GA 30345-2739 | 2014-12-23 |
| 1770836884 | Dublin Vamc | Clinic/Center | 1824 Ridge Avenue North, Tifton, GA 31794-9998 | 2012-10-26 |
| 1669729570 | Atlanta Vamc | Clinic/Center | 180 Martin Dr., Carrollton, GA 30117-2425 | 2012-08-09 |
| Find all providers with the same taxonomy | ||||
| City | STATESBORO |
| Zip Code | 30458 |
Please comment or provide details below to improve the information on AUGUSTA 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.