ST. LOUIS JC VAMC (NPI# 1578616892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578616892 |
| Entity Type | Organization |
| Organization Name | ST. LOUIS JC VAMC |
| Other Organization Name | MADISONVILLE VA CLINIC |
| Practice Address |
99 Stagecoach Rd Madisonville KY 42431-8009 |
| Mailing Address |
Po Box 94462 Cleveland OH 44101-4462 |
| Practice Telephone | 9135784409 |
| Mailing Telephone | 9135784409 |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2020-11-06 |
| 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 |
|---|---|
| Hanson VA CBOC | Other Name - Individual/Organization |
| Madisonville VA Clinic | 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 |
| 1902840622 | St. Louis Jc Vamc | Clinic/Center | 4105 N Water Tower Pl, Mount Vernon, IL 62864-6296 | 2006-06-15 |
| 1508809948 | St. Louis Jc Vamc | Clinic/Center | 2420 Linwood Dr, Suite 3, Paragould, AR 72450-6122 | 2006-06-14 |
| Street Address |
99 STAGECOACH RD |
| City | MADISONVILLE |
| State | KY |
| Zip Code | 42431-8009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982885455 | Chella Periyanayagam | Psychologist | 99 Stagecoach Rd, Madisonville, KY 42431-8009 | 2007-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750846309 | Sarah Davenport Ziegler | Registered Nurse | 3050 Nebo Rd, Madisonville, KY 42431 | 2019-02-08 |
| 1134604903 | Kelsey Dawn Wilson | Occupational Therapist | 425 Island Ford Rd, Madisonville, KY 42431 | 2018-09-27 |
| 1174006209 | Shaun Vickery | Physical Therapist | 425 Island Ford Road, Madisonville, KY 42431 | 2018-09-14 |
| 1881115384 | Filza Tajik | Speech-Language Pathologist | 1305-1 W. Noel Ave, Unit 1, Madisonville, KY 42431 | 2017-07-05 |
| 1245769280 | Susan Hart | Student in an Organized Health Care Education/Training Program | 200 Clinic Drive, Third North, Madisonville, KY 42431 | 2017-06-05 |
| 1811363880 | Cory Eakins | Nutritionist | 2223 S Main St, Madisonville, KY 42431 | 2015-08-13 |
| 1932598257 | Deidra Boyken | Counselor | 145 E. Center Street Suite 1d, Madisonville, KY 42431 | 2015-01-12 |
| 1841602398 | Jessica France | Occupational Therapist | 339 S Seminary St, Madisonville, KY 42431 | 2014-06-02 |
| 1497097562 | Sunrise Children's Services | Community/Behavioral Health | 1079 Thornberry Dr Ste 203, Madisonville, KY 42431 | 2013-03-26 |
| 1013275023 | Creasha King | Counselor | 1079 Thornberry Dr Ste B, Madisonville, KY 42431 | 2012-04-26 |
| Find all providers in zip 42431 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619116399 | St. Louis Jc Vamc | Clinic/Center | 1253 Paris Rd, Suite A, Mayfield, KY 42066-4989 | 2009-02-19 |
| 1508015074 | Louisville Vamc | Clinic/Center | 1911 Us Highway 227, Carrollton, KY 41008-8037 | 2008-09-09 |
| 1952458960 | Cincinnati Vamc | Clinic/Center | 7310 Turfway Road, Suite 510, Florence, KY 41042-1385 | 2007-01-04 |
| 1003855966 | Lexington Vamc | Clinic/Center | 300 Medpark Drive, Somerset, KY 42503-9998 | 2006-06-06 |
| 1366480436 | Huntington Vamc | Clinic/Center | 5230 Ky Route 321, Suite 8, Prestonsburg, KY 41653-9169 | 2006-06-02 |
| 1518910025 | Louisville Vamc | Clinic/Center | 9208 Taylorsville Road, Louisville, KY 40299-9998 | 2006-05-18 |
| 1639120215 | Nashville Vamc | Clinic/Center | 600 Us 31 West Bypass, Suite 12, Bowling Green, KY 42101-4905 | 2006-05-16 |
| 1972739936 | Nashville Vamc | Clinic/Center | 1102 S Virginia St, Second Floor, Hopkinsville, KY 42240-3579 | 2009-06-04 |
| 1528205648 | Lexington Vamc | Clinic/Center | 209 Pauline Dr, Berea, KY 40403-8889 | 2009-01-12 |
| 1407005481 | St. Louis Jc Vamc | Clinic/Center | 3400 New Hartford Rd, Owensboro, KY 42303-1705 | 2008-09-15 |
| Find all providers with the same taxonomy | ||||
| City | MADISONVILLE |
| Zip Code | 42431 |
Please comment or provide details below to improve the information on ST. LOUIS JC 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.