DETROIT VAMC (NPI# 1609815034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609815034 |
| Entity Type | Organization |
| Organization Name | DETROIT VAMC |
| Other Organization Name | PONTIAC VA CBOC |
| Practice Address |
44200 Woodward Ave Suite 208 Pontiac MI 48341-5045 |
| Mailing Address |
Po Box 5426 Madison WI 53705-0426 |
| Practice Telephone | 6088217200 |
| Mailing Telephone | 6088217200 |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2017-03-01 |
| 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 |
|---|---|
| Pontiac VA CBOC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497143374 | Detroit Vamc | Clinic/Center | 301 Piquette Street, Detroit, MI 48202-3513 | 2014-12-31 |
| 1154781615 | Detroit Vamc | Psychiatric Residential Treatment Facility | 4777 E Outer Dr, Detroit, MI 48234-3241 | 2016-02-26 |
| 1922048750 | Detroit Vamc | Clinic/Center | 7470 Brockway Rd, Brockway, MI 48097-3458 | 2006-06-08 |
| 1366491136 | Detroit Vamc | General Acute Care Hospital | 4646 John R St, Detroit, MI 48201-1916 | 2006-05-09 |
| 1184682007 | Detroit Vamc | Department of Veterans Affairs (VA) Pharmacy | 4646 John R St, Detroit, MI 48201-1916 | 2006-05-02 |
| Street Address |
44200 WOODWARD AVE SUITE 208 |
| City | PONTIAC |
| State | MI |
| Zip Code | 48341-5045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649262080 | Kay Alexa Robertson | Internal Medicine | 44200 Woodward Ave, Suite 205, Pontiac, MI 48341-5045 | 2005-08-22 |
| 1487195566 | Verna Renee Dubord | Registered Nurse | 44200 Woodward Ave, Suite 209, Pontiac, MI 48341-5045 | 2017-03-09 |
| 1366809519 | Pampered Child | In Home Supportive Care | 44200 Woodward Ave, Ste 205, Pontiac, MI 48341-5045 | 2016-01-19 |
| 1093184111 | Ashley Maxwell | Physical Therapist | 44200 Woodward Ave, Suite 11, Pontiac, MI 48341-5045 | 2015-09-18 |
| 1841566866 | Erin Mcevilly Grindling | Audiologist | 44200 Woodward Ave, Pontiac, MI 48341-5045 | 2012-03-23 |
| 1346537289 | Roy J Pullukat | Pediatrics | 44200 Woodward Ave, Suite 103, Pontiac, MI 48341-5045 | 2011-06-29 |
| 1528294824 | Obstetrics and Gynecology Center of Michigan, Pllc | Obstetrics & Gynecology | 44200 Woodward Ave, Suite 101, Pontiac, MI 48341-5045 | 2009-06-02 |
| 1043460512 | Michael Scott Hayes | Audiologist | 44200 Woodward Ave, Suite 200, Pontiac, MI 48341-5045 | 2008-09-22 |
| 1699934554 | Michigan Infectious Disease Consultants PC | Internal Medicine | 44200 Woodward Ave, Suite 101, Pontiac, MI 48341-5046 | 2008-06-05 |
| 1427234863 | Bloomfield Pharmacy North PC | Pharmacy | 44200 Woodward Ave, Ste 107, Pontiac, MI 48341-5045 | 2008-01-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003415837 | Brittany Taylor Shandor | Registered Nurse | 32 East, 1200 Telegraph Rd, Pontiac, MI 48341 | 2020-10-22 |
| 1013534999 | Siddharth Chopra | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue Saint Joseph Mercy Oakland Hospit, Medical Education H-23, Pontiac, MI 48341 | 2020-06-26 |
| 1972120962 | Tara Elizabeth Bjorklund | Obstetrics & Gynecology | 44405 Woodward Ave - H23, St. Joseph Mercy Oakland - Gme Office, Pontiac, MI 48341 | 2020-06-25 |
| 1245856145 | Sarah Fatima | Student in an Organized Health Care Education/Training Program | St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-17 |
| 1407471188 | Tyler Schaefer | Emergency Medical Technician, Basic | 32east 1200 N. Telegraph Rd., Pontiac, MI 48341 | 2020-06-09 |
| 1639793581 | Yash Kirankumar Varma | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, Medical Education H-23, Pontiac, MI 48341 | 2020-06-05 |
| 1326661687 | Fnu Kavita | Student in an Organized Health Care Education/Training Program | C/o Shelly Casey, St. Joseph Mercy Oakland Hospital, 44405 Woodward Avenue Medical Education - H23, Pontiac, MI 48341 | 2020-05-21 |
| 1801452578 | Lolita Curry | Registered Nurse | 32 East 1200 Telegraph, Pontiac, MI 48341 | 2019-05-17 |
| 1619530060 | Priyadarshini Dixit | Student in an Organized Health Care Education/Training Program | 44405 Woodward Avenue, St. Joseph Mercy Oakland Hospita, Pontiac, MI 48341 | 2019-04-20 |
| 1891358370 | Anil Gurpersaud | Student in an Organized Health Care Education/Training Program | 44405 Woodward Ave., St. Joseph Mercy Oakland, Pontiac, MI 48341 | 2019-04-19 |
| Find all providers in zip 48341 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134693500 | Duraid Hadi | Clinic/Center | 29650 Newberry Ct, Farmington Hills, MI 48331-1643 | 2019-01-18 |
| 1043722325 | Ann Arbor Vamc | Clinic/Center | 2500 Green Rd Ste 200, Ann Arbor, MI 48105-1573 | 2017-10-26 |
| 1538520028 | Saginaw Vamc | Clinic/Center | 880 Munson Avenue, Traverse City, MI 49686-3661 | 2016-03-11 |
| 1497143374 | Detroit Vamc | Clinic/Center | 301 Piquette Street, Detroit, MI 48202-3513 | 2014-12-31 |
| 1114334174 | Iron Mountain Vamc | Clinic/Center | 813 East Lakeshore Drive, Manistique, MI 49854-1683 | 2014-07-22 |
| 1326329962 | Saginaw Vamc | Clinic/Center | 14540 N Mackinaw Hwy, Mackinaw City, MI 49701-9507 | 2011-09-08 |
| 1194010173 | Saginaw Vamc | Clinic/Center | 1909 North Mitchell St, Cadillac, MI 49601-1139 | 2011-06-17 |
| 1720028319 | Iron Mountain Vamc | Clinic/Center | 629 W Cloverland Dr, Suite 1, Ironwood, MI 49938-1006 | 2006-06-08 |
| 1649218058 | Battle Creek Vamc | Clinic/Center | 5000 Hakes Drive, Muskegon, MI 49441-5574 | 2006-06-04 |
| 1588602254 | Iron Mountain Vamc | Clinic/Center | 509 Osborn Blvd Ste 306, Sault Sainte Marie, MI 49783-2071 | 2006-06-03 |
| 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.