VA MEDICAL CENTER (NPI# 1609806504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609806504 |
| Entity Type | Organization |
| Organization Name | VA MEDICAL CENTER |
| Practice Address |
940 Capella Creek Way Grayson GA 30017-1578 |
| Practice Telephone | 7709723658 |
| Mailing Telephone | 7709723658 |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. VICKY DARLENE CAMPBELL-HEMMING (NURSE MANAGER) |
| Authorized Official Telephone | 4043216111 |
| Authorized Official Credential | RN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 286500000X | Military Hospital | GA | Hospitals |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245785179 | Va Medical Center | Military Hospital | 5939 Cedros Ave Apt A, Van Nuys, CA 91411-3104 | 2016-08-21 |
| 1104216332 | Va Medical Center | Military Hospital | 10707 W Interstate 10 Apt 436, San Antonio, TX 78230-1674 | 2015-01-26 |
| 1295178796 | Va Medical Center | Military Hospital | 16 Charles St, 3rd Floor, Lincoln, RI 02865-1906 | 2013-04-15 |
| 1487905311 | Va Medical Center | General Acute Care Hospital | 292 Sherwood Dr, Huntington, WV 25704-9460 | 2012-10-02 |
| 1033479316 | Va Medical Center | Chronic Disease Hospital | 500 Trinity Ln N Apt 5204, St Petersburg, FL 33716-1236 | 2012-05-21 |
| 1134495682 | Va Medical Center | General Acute Care Hospital | 5015 S Desoto Ct, New Berlin, WI 53151-7664 | 2012-03-29 |
| 1386952893 | Va Medical Center | General Acute Care Hospital | 6208 Krandon Drive, Raleigh, NC 27603-4928 | 2010-09-17 |
| 1093049520 | Va Medical Center | Military Hospital | 5416 Orange Valley Dr, Lakeland, FL 33813-2649 | 2009-09-30 |
| 1275784050 | Va Medical Center | Skilled Nursing Facility | 236 Pochin Pl, Hampton, VA 23661-2902 | 2008-10-10 |
| 1154587475 | Va Medical Center | General Acute Care Hospital | 4001 24th Ave W, Seattle, WA 98199-1505 | 2008-08-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | VA MEDICAL CENTER | 4101 Woolworth Ave, Omaha, NE 68105-1850 |
| System for Award Management (SAM) Entities | VA MEDICAL CENTER 581/90C | 1540 Spring Valley Dr, Huntington, WV 25704-9300 |
| Street Address |
940 CAPELLA CREEK WAY |
| City | GRAYSON |
| State | GA |
| Zip Code | 30017-1578 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588140859 | Butterfly Development, LLC | Community Based Residential Treatment Facility, Mental Illness | 1911 Grayson Highway, Suite 8-242, Grayson, GA 30017 | 2018-07-19 |
| 1811417132 | Yva Gauthier | Nurse Practitioner | 1620 Terry Mill Lane, Grayson, GA 30017 | 2017-06-27 |
| 1023341518 | Christine R Petro, Psy.d., LLC | Psychologist | 69 Grayson New Hope Rd, Grayson, GA 30017 | 2009-09-15 |
| 1902097579 | Zain Odeh Dabbas | Dentist | 2594 Loganviile Hwy, # 102, Grayson, GA 30017 | 2007-08-07 |
| 1619078276 | Primary Foot & Ankle Care | Podiatrist | 862 Amber Hill Ct, Grayson, GA 30017 | 2006-09-26 |
| 1700878170 | James Michael Long | Dentist | 2518 Loganville Hwy, Grayson, GA 30017 | 2005-08-22 |
| 1629556717 | Mason Moriah Earp | Physical Therapist | 2065 Grayson Hwy Ste B, Grayson, GA 30017 | 2018-08-01 |
| 1811482201 | Matthew Ntomoo Lo | Physical Therapy Assistant | 2065 Grayson Hwy Ste B, Grayson, GA 30017 | 2018-06-27 |
| 1144460668 | Alisa M Nelson-wade | Dentist | 2219 Loganville Hwy, Hwy 20, Grayson, GA 30017 | 2009-02-24 |
| 1003321662 | Grace Care Ambulance Transport, LLC | Ambulance | 516 Sosebee Farm Rd Unit 531, Grayson, GA 30017-0118 | 2017-12-05 |
| Find all providers in zip 30017 | ||||
| Taxonomy Code | 286500000X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| A health care facility operated by the Department of Defense. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982154241 | Department of Veteran Affairs | Military Hospital | 1122 Providence Way, Lawrenceville, GA 30046-3316 | 2016-10-11 |
| 1417307190 | Sanghyub Lee | Military Hospital | 411 E 9th St # 74, Fort Stewart, GA 31314-5036 | 2016-06-14 |
| 1770956252 | Clara Mccomb | Military Hospital | 6600 Van Aalst Blvd., Fort Benning, GA 31905 | 2015-11-05 |
| 1790113348 | Veronica Garrett | Military Hospital | 804 Rosemont Pkwy, Roswell, GA 30076-4934 | 2013-10-17 |
| 1780942664 | Martin Army Community Hospital | Military Hospital | 8830 Watkins Ave, Fort Benning, GA 31905-5529 | 2012-04-27 |
| 1629357934 | United States Army | Military Hospital | 300 W Hospital Rd Rm 7a-46, Fort Gordon, GA 30905-5741 | 2011-08-04 |
| 1093947780 | Army | Military Hospital | 202 Vineyard Way, Apt. 601, Evans, GA 30809 | 2009-08-14 |
| 1497953012 | Va Medical Center | Military Hospital | 1401 Post Oak Dr Apt F, Clarkston, GA 30021-3145 | 2007-07-05 |
| 1508312711 | Martin Army Community Hospital | Military Hospital | Martin Army Community Hospital, 6600 Van Aalst Blvd, Bldg 9250, Fort Benning, GA 31905 | 2016-08-28 |
| 1508312869 | Debbie Speed-simmons | Military Hospital | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2016-08-28 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on VA MEDICAL CENTER.
| 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.