ST. LOUIS JC VAMC (NPI# 1508809948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508809948 |
Entity Type | Organization |
Organization Name | ST. LOUIS JC VAMC |
Other Organization Name | PARAGOULD VA CBOC |
Practice Address |
2420 Linwood Dr Suite 3 Paragould AR 72450-6122 |
Mailing Address |
Po Box 94462 Cleveland OH 44101-4462 |
Practice Telephone | 9135784409 |
Mailing Telephone | 9135784409 |
Enumeration Date | 2006-06-14 |
Last Update Date | 2018-01-17 |
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 |
---|---|
Paragould VA CBOC | Other Name - Individual/Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1114317369 | St. Louis Jc Vamc | Clinic/Center | 2600 Washington Boulevard, St. Louis, MO 63103-1420 | 2015-01-27 |
1396135513 | St. Louis Jc Vamc | Clinic/Center | 3615 Olive Street, St. Louis, MO 63108-3604 | 2015-01-26 |
1558751776 | St. Louis Jc Vamc | Clinic/Center | 3403 Heartland Street, Marion, IL 62959-6393 | 2015-01-26 |
1992067995 | St. Louis Jc Vamc | Clinic/Center | 1130 E Walnut St, Suite 100, Carbondale, IL 62901-5007 | 2012-06-14 |
1497012652 | St. Louis Jc Vamc | Clinic/Center | 608 Rollie Moore Drive, Harrisburg, IL 62946-9998 | 2012-04-12 |
1902198922 | St. Louis Jc Vamc | Clinic/Center | 1627 A Roy Dr, Washington, MO 63090-5008 | 2011-05-10 |
1619116399 | St. Louis Jc Vamc | Clinic/Center | 1253 Paris Rd, Suite A, Mayfield, KY 42066-4989 | 2009-02-19 |
1518155878 | St. Louis Jc Vamc | Clinic/Center | 6854 Parker Rd, Florissant, MO 63033-5313 | 2007-10-11 |
1578616892 | St. Louis Jc Vamc | Clinic/Center | 99 Stagecoach Rd, Madisonville, KY 42431-8009 | 2007-01-19 |
1902840622 | St. Louis Jc Vamc | Clinic/Center | 4105 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2006-06-15 |
Street Address |
2420 LINWOOD DR SUITE 3 |
City | PARAGOULD |
State | AR |
Zip Code | 72450-6122 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417509886 | Alexander Laffoon | Case Manager/Care Coordinator | 2420 Linwood Dr, Paragould, AR 72450-6122 | 2019-07-15 |
1891253670 | Kaylyn Wynn | Case Manager/Care Coordinator | 2420 Linwood Dr, Paragould, AR 72450-6122 | 2019-03-11 |
1285108928 | Whitney Lee Maxwell | Case Manager/Care Coordinator | 2420 Linwood Dr, Paragould, AR 72450-6122 | 2019-01-16 |
1326516451 | Kristen Nicole Wooten | Case Manager/Care Coordinator | 2420 Linwood Dr, Paragould, AR 72450-6122 | 2018-11-07 |
1700365509 | April Rogers | Case Manager/Care Coordinator | 2420 Linwood Dr, Paragould, AR 72450-6122 | 2018-08-13 |
1497232631 | Jordan Faulkner | Counselor | 2420 Linwood Dr, Paragould, AR 72450 | 2018-07-20 |
1497261192 | Sara Kay Mcneil | Case Manager/Care Coordinator | 2420 Linwood Dr, Paragould, AR 72450-6122 | 2017-12-18 |
1881110930 | Vincent Tyrone Livingston Jr. | Case Manager/Care Coordinator | 2420 Linwood Dr, Paragould, AR 72450 | 2017-08-21 |
1457877649 | Denise Middleton | Case Manager/Care Coordinator | 2420 Linwood Dr, Paragould, AR 72450-6122 | 2017-08-18 |
1639540966 | Samantha Brown | Case Manager/Care Coordinator | 2420 Linwood Dr, Paragould, AR 72450-6122 | 2015-10-13 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1063029460 | Onward and Upward Counseling, Pllc | Counselor | 100 North Rockingchair Road, Ste 3, Paragould, AR 72450 | 2020-09-29 |
1871104182 | Michele Lynn Jones | Technician | 2905 Stonegate Dr, Paragould, AR 72450 | 2020-08-11 |
1205457405 | Arkansas Methodist Hospital Corp. | Family Medicine | 1000 W. Kinshighway, Suite 14, Paragould, AR 72450 | 2020-04-29 |
1053968222 | Stewart Pediatric Therapy LLC | Occupational Therapist | 1908 Mockingbird Lane, Suite A, Paragould, AR 72450 | 2019-08-22 |
1821575911 | Ashley Brooke Mcleskey | Physical Therapy Assistant | 9504 Hwy 135 N, Paragould, AR 72450 | 2018-07-23 |
1437660925 | Susan Leigh Boling | Behavioral Analyst | 3171 Green 905 Road, Paragould, AR 72450 | 2017-10-24 |
1518481589 | Amy Elms | Nurse Practitioner | 1000 W Kingshighway Ste 3, Paragould, AR 72450 | 2017-08-01 |
1073065074 | Sarah Katherine Medley | Case Manager/Care Coordinator | 1101 West Morgan, Paragould, AR 72450 | 2016-10-26 |
1285097949 | Chelsea Lee Thompson | Family Medicine | 1110 W. Kingshighway, Paragould, AR 72450 | 2016-03-31 |
1609234269 | Bethel Burris Oliver | Dentist | 2713 W Kings Highway, Paragould, AR 72450 | 2016-02-10 |
Find all providers in zip 72450 |
Taxonomy Code | 261QV0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | VA |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528456811 | Fayetteville Vamc | Clinic/Center | 216 East Township Street, Fayetteville, AR 72703-2818 | 2015-01-08 |
1073821518 | Little Rock Vamc | Clinic/Center | 1520 E Dave Ward Dr, Conway, AR 72032-9649 | 2010-09-17 |
1831415751 | Fayetteville Vamc | Clinic/Center | 2713 W Commercial St, Ozark, AR 72949-3409 | 2010-04-16 |
1649401316 | Memphis Vamc | Clinic/Center | 125 Quarles Ln, West Helena, AR 72390-1923 | 2009-07-29 |
1417996489 | Shreveport Vamc | Clinic/Center | 910 Realtor Road, Texarkana, AR 71854-1020 | 2006-06-05 |
1063450617 | Little Rock Vamc | Clinic/Center | 759 Highway 62 E, Suite 331, Mountain Home, AR 72653-3260 | 2006-06-04 |
1861439697 | Little Rock Vamc | Clinic/Center | 300 Morrow St S, Mena, AR 71953 | 2006-06-01 |
1619923398 | Memphis Vamc | Clinic/Center | 2908 S Caraway Rd Ste B, Jonesboro, AR 72401-7306 | 2006-05-25 |
1215982582 | Little Rock Vamc | Clinic/Center | 177 Sawtooth Oak St, Hot Springs, AR 71901-7160 | 2006-05-24 |
1215980164 | Little Rock Vamc | Clinic/Center | 1702 N West Ave, El Dorado, AR 71730 | 2006-05-19 |
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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.