PRESCOTT VAMC (NPI# 1477504975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477504975 |
| Entity Type | Organization |
| Organization Name | PRESCOTT VAMC |
| Other Organization Name | ANTHEM VA CLINIC |
| Practice Address |
41810 N Venture Dr Bldg B Anthem AZ 85086-3169 |
| Mailing Address |
Po Box 94411 Cleveland OH 44101-4411 |
| Practice Telephone | 7023413152 |
| Mailing Telephone | 7023413152 |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2018-05-03 |
| 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 |
|---|---|
| ANTHEM VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558759837 | Prescott Vamc | Clinic/Center | 33 West Vista Drive, Holbrook, AZ 86025-1844 | 2015-01-08 |
| 1356739650 | Prescott Vamc | Clinic/Center | 801 North Navajo Drive, Suite B, Page, AZ 86040-9998 | 2015-01-08 |
| 1952345076 | Prescott Vamc | Clinic/Center | 1300 W University Ave, #200, Flagstaff, AZ 86001-7214 | 2006-06-16 |
| 1770539561 | Prescott Vamc | Clinic/Center | 2668 Hualapai Mountain Rd, Kingman, AZ 86401-8387 | 2006-05-25 |
| 1477505493 | Prescott Vamc | Clinic/Center | 501 S Willard St, Cottonwood, AZ 86326-8120 | 2006-05-17 |
| 1275583684 | Prescott Vamc | General Acute Care Hospital | 500 N Highway 89, Prescott, AZ 86313-5001 | 2006-05-10 |
| 1801854328 | Prescott Vamc | Department of Veterans Affairs (VA) Pharmacy | 500 N Hwy 89, Prescott, AZ 86313-5001 | 2006-05-03 |
| 1669857975 | Prescott Vamc | Clinic/Center | Highway 264, Mile Post 388, Polacca, AZ 86042-9998 | 2015-07-28 |
| 1184009490 | Prescott Vamc | Clinic/Center | Us Highway 160, Kayenta, AZ 86033-9998 | 2015-07-28 |
| 1891183182 | Prescott Vamc | Clinic/Center | Highway 191 and Hospital Drive, Chinle, AZ 86503-9998 | 2015-01-08 |
| Street Address |
41810 N VENTURE DR BLDG B |
| City | ANTHEM |
| State | AZ |
| Zip Code | 85086-3169 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097703 | Cindy Ryanto | Pharmacist | 39508 W Daisy Mountain Dr, Phoenix, AZ 85086 | 2020-09-15 |
| 1912559857 | Cathey Michelle Allen | Massage Therapist | 39006 N 11th Ave, Phoenix, AZ 85086 | 2019-07-11 |
| 1174000871 | Anthem Eye Group Pllc | Optometrist | 4205 W Anthem Way #101, Anthem, AZ 85086 | 2018-07-25 |
| 1366982449 | Angela Ann Childs | Registered Nurse | 42104 N Venture Dr Ste D118, Anthem, AZ 85086 | 2017-03-08 |
| 1144772054 | Joe Bezerra | Specialist | 39818 N Bell Meadow Trl, Phoenix, AZ 85086 | 2016-10-26 |
| 1669821252 | Arizona Procedural Center | Clinic/Center | 3655 West Anthem Way, Suite 109 Box 272, Athem, AZ 85086 | 2016-06-06 |
| 1124499280 | Shane Carr | Physical Therapist | 39716 N 7th St, Phoenix, AZ 85086 | 2015-10-15 |
| 1790174167 | Kelly Christine Collins | Dermatology | 42211 N 41st Dr. #a109, Phoenix, AZ 85086 | 2015-01-22 |
| 1174953913 | Sung Ae Lee | Radiology | 820 W. Ravina Lane, Anthem, AZ 85086 | 2013-11-14 |
| 1881034080 | Bryan Michael Hays | Dentist | 40411 N Capra Way, Anthem, AZ 85086 | 2013-07-02 |
| Find all providers in zip 85086 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013457704 | Tucson Vamc | Clinic/Center | 1179 E Cottonwood Lane, Suite 1, Casa Grande, AZ 85122-2969 | 2017-03-01 |
| 1104366897 | Tucson Vamc | Clinic/Center | 157 North Coronado Drive, Suite B, Sierra Vista, AZ 85635-6361 | 2017-03-01 |
| 1619352077 | Phoenix Vamc | Clinic/Center | 1500 East Thomas Road, Suite 106, Phoenix, AZ 85014-5748 | 2015-07-28 |
| 1558759837 | Prescott Vamc | Clinic/Center | 33 West Vista Drive, Holbrook, AZ 86025-1844 | 2015-01-08 |
| 1356739650 | Prescott Vamc | Clinic/Center | 801 North Navajo Drive, Suite B, Page, AZ 86040-9998 | 2015-01-08 |
| 1265785364 | Phoenix Vamc | Clinic/Center | 11390 East Via Linda Road, Suite 105, Scottsdale, AZ 85259-4075 | 2012-10-26 |
| 1033345624 | Phoenix Vamc | Clinic/Center | 9424 N 25th Ave, Phoenix, AZ 85021-2714 | 2009-06-09 |
| 1811176530 | Cthvamc | Clinic/Center | 239 W Utopia Rd, Phoenix, AZ 85027-4738 | 2007-10-30 |
| 1952345076 | Prescott Vamc | Clinic/Center | 1300 W University Ave, #200, Flagstaff, AZ 86001-7214 | 2006-06-16 |
| 1235173931 | Tucson Vamc | Clinic/Center | 101 N Coronado Dr Ste A, Building 45006, Sierra Vista, AZ 85635-6359 | 2006-06-15 |
| Find all providers with the same taxonomy | ||||
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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.