ST. LOUIS JC VAMC (NPI# 1619116399) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1619116399 |
Entity Type | Organization |
Organization Name | ST. LOUIS JC VAMC |
Other Organization Name | MAYFIELD VA CBOC |
Practice Address |
1253 Paris Rd Suite A Mayfield KY 42066-4989 |
Mailing Address |
Po Box 94462 Cleveland OH 44101-4462 |
Practice Telephone | 9135784409 |
Mailing Telephone | 9135784409 |
Enumeration Date | 2009-02-19 |
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 |
---|---|
Mayfield 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 |
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 |
1508809948 | St. Louis Jc Vamc | Clinic/Center | 2420 Linwood Dr, Suite 3, Paragould, AR 72450-6122 | 2006-06-14 |
Street Address |
1253 PARIS RD SUITE A |
City | MAYFIELD |
State | KY |
Zip Code | 42066-4989 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154746063 | Zenith Perpignani | Nurse Practitioner | 1253 Paris Rd, Mayfield, KY 42066-4989 | 2014-02-28 |
1114358157 | Donna Hedrick | Social Worker | 1253 Paris Rd, Mayfield, KY 42066-4989 | 2013-12-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760031959 | Snh Derby Tenant LLC | Assisted Living Facility | 1517 West Broadway Street, Mayfield, KY 42066 | 2019-09-10 |
1033674254 | Mind, Body, Soul, LLC | Clinic/Center | 1325 Us 45 S, Suite C, Mayfield, KY 42066 | 2019-02-01 |
1699288936 | Kimberly Kaye Gooch | Developmental Therapist | 3907 State Route 303, Mayfield, KY 42066 | 2017-11-08 |
1538604657 | Courtney L Coleman | Nurse Practitioner | 1029 Medical Center Cir Ste 200, Mayfield, KY 42066 | 2016-12-28 |
1659814721 | Bertha Workman | Voluntary or Charitable | 331 South 7th Street, Mayfield, KY 42066 | 2016-11-22 |
1699174052 | Laura Dassing | Counselor | 1325 Hwy 45 N, Mayfield, KY 42066 | 2014-08-21 |
1275947905 | Wkda Services LLC | Community/Behavioral Health | 1325 U S Hwy 45n, Mayfield, KY 42066 | 2014-06-20 |
1538594247 | Young Healthcare LLC | Chiropractor | 1011 Paris Road #341, Mayfield, KY 42066 | 2013-09-12 |
1811335649 | Donald Bennett Dowdy | Dentist | 236 N. 6th St., Mayfield, KY 42066 | 2013-06-14 |
1578822623 | Wanda Bingham Marshall | Counselor | 325 South 8th Street, West Kentucky Counseling Center, Mayfield, KY 42066 | 2012-05-10 |
Find all providers in zip 42066 |
Taxonomy Code | 261QV0200X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | VA |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508015074 | Louisville Vamc | Clinic/Center | 1911 Us Highway 227, Carrollton, KY 41008-8037 | 2008-09-09 |
1578616892 | St. Louis Jc Vamc | Clinic/Center | 99 Stagecoach Rd, Madisonville, KY 42431-8009 | 2007-01-19 |
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 |
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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.