PHOENIX VAMC (NPI# 1629582184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629582184 |
| Entity Type | Organization |
| Organization Name | PHOENIX VAMC |
| Other Organization Name | PHOENIX VA MOBILE CLINIC |
| Practice Address |
650 E Indian School Rd Phoenix AZ 85012-1839 |
| Mailing Address |
Po Box 94413 Cleveland OH 44101-4413 |
| Practice Telephone | 7023413152 |
| Mailing Telephone | 7023413152 |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2017-11-20 |
| Authorized Official Name | ERIN DENISE 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 |
|---|---|
| PHOENIX VA MOBILE CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619352077 | Phoenix Vamc | Clinic/Center | 1500 East Thomas Road, Suite 106, Phoenix, AZ 85014-5748 | 2015-07-28 |
| 1265785364 | Phoenix Vamc | Clinic/Center | 11390 East Via Linda Road, Suite 105, Scottsdale, AZ 85259-4075 | 2012-10-26 |
| 1033345624 | Phoenix Vamc | Clinic/Center | 9424 N 25th Ave, Phoenix, AZ 85021-2714 | 2009-06-09 |
| 1437197902 | Phoenix Vamc | Clinic/Center | 3285 S Val Vista Dr, Gilbert, AZ 85297-7000 | 2006-06-04 |
| 1215974696 | Phoenix Vamc | Clinic/Center | 903 E Highway 260, Suite 2, Payson, AZ 85531-4972 | 2006-06-02 |
| 1205874351 | Phoenix Vamc | Clinic/Center | 2450 E Show Low Lake Rd, Suite 1, Show Low, AZ 85901-7953 | 2006-06-02 |
| 1174065791 | Phoenix Vamc | Clinic/Center | 5040 N 15th Ave, Phoenix, AZ 85015-3328 | 2016-11-14 |
| 1104286418 | Phoenix Vamc | Psychiatric Residential Treatment Facility | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2016-02-29 |
| 1053586545 | Phoenix Vamc | Clinic/Center | 5860 S Hospital Dr, Suite 111, Globe, AZ 85501-9449 | 2008-04-25 |
| 1598704512 | Phoenix Vamc | Clinic/Center | 13985 W Grand Ave, Suite 101, Surprise, AZ 85374-3625 | 2006-06-05 |
| Street Address |
650 E INDIAN SCHOOL RD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012-1839 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679579213 | Carlos J Carrera | Psychiatry & Neurology | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2005-06-27 |
| 1568063220 | Lucas Alan Bodine | Physical Therapist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-11-07 |
| 1417558206 | Elijah Robles Lazo | Physical Medicine & Rehabilitation | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-11-06 |
| 1871191486 | Samantha Roberts | Social Worker | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-10-15 |
| 1760099667 | Dino Alihodzic | Psychologist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-09-25 |
| 1659986768 | Jennica Lynne Failner | Social Worker | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-09-15 |
| 1568074557 | Danielle Marie Mcgraw | Psychologist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-08-20 |
| 1841802055 | Courtney Loera | Pharmacist | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-08-19 |
| 1659980613 | Nakia Andrea Willis | Social Worker | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-07-27 |
| 1487263430 | Lauren Larue Waznik | Dietitian, Registered | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2020-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205417 | Diligence Physical Therapy and Wellness, Pllc | Physical Therapist | 3101 N. Central Avenue, Suite 183 # 518, Phoenix, AZ 85012 | 2020-08-17 |
| 1962023135 | Kelee Jade Forst | Student in an Organized Health Care Education/Training Program | 4001 N Third Street, Suite 290, Phoenix, AZ 85012 | 2020-04-29 |
| 1659911428 | Thomas James Blake | Social Worker | Phoenix Va Health Care System, 650 E Indian School Road, Phoenix, AZ 85012 | 2020-01-09 |
| 1598259467 | Luis F Fong | Registered Nurse | 3620 N. 3rd Street, Phoenix, AZ 85012 | 2018-06-14 |
| 1881196335 | Phoenix Surgical Solutions Pllc | Surgery | 6120 W Bell Rd Suite 130, Glendale, AZ 85012 | 2018-03-01 |
| 1679082523 | Christopher Ferguson | Physician Assistant | 1313 E. Osborn Rd., Ste 150, Phoenix, AZ 85012 | 2017-09-22 |
| 1861911323 | Viet Quoc Truong | Physician Assistant | 650 E Indian School Rd # 1, Phoenix, AZ 85012 | 2017-09-15 |
| 1720506389 | Erin Lynne Cody | Nurse Practitioner | 3003 N. 3rd St, Phoenix, AZ 85012 | 2017-09-05 |
| 1346694627 | Sharareh Najafi | Psychologist | 3450 N. 3rd Street, Phoenix, AZ 85012 | 2016-04-22 |
| 1548635824 | Rebekah June Daroff | Specialist/Technologist | 352 N Camelback Rd, Phoenix, AZ 85012 | 2015-12-11 |
| Find all providers in zip 85012 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619352077 | Phoenix Vamc | Clinic/Center | 1500 East Thomas Road, Suite 106, Phoenix, AZ 85014-5748 | 2015-07-28 |
| 1033345624 | Phoenix Vamc | Clinic/Center | 9424 N 25th Ave, Phoenix, AZ 85021-2714 | 2009-06-09 |
| 1811176530 | Cthvamc | Clinic/Center | 239 W Utopia Rd, Phoenix, AZ 85027-4738 | 2007-10-30 |
| 1174065791 | Phoenix Vamc | Clinic/Center | 5040 N 15th Ave, Phoenix, AZ 85015-3328 | 2016-11-14 |
| 1619422052 | Veterans Health Administration | Clinic/Center | 2141 E Camelback Rd, Suite 210, Phoenix, AZ 85016-4764 | 2016-08-15 |
| 1790022234 | Phoenix Va Health Care System | Clinic/Center | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2013-01-03 |
| 1811292923 | Phoenix Va Medical Center | Clinic/Center | 650 E Indian School Rd, Phoenix, AZ 85012-1839 | 2011-01-20 |
| 1831138270 | Phoenix Vamc | Clinic/Center | 9250 W Thomas Rd, Suite 400, Phoenix, AZ 85037-3382 | 2006-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013457704 | Tucson Vamc | Clinic/Center | 1179 E Cottonwood Lane, Suite 1, Casa Grande, AZ 85122-2969 | 2017-03-01 |
| 1104366897 | Tucson Vamc | Clinic/Center | 157 North Coronado Drive, Suite B, Sierra Vista, AZ 85635-6361 | 2017-03-01 |
| 1558759837 | Prescott Vamc | Clinic/Center | 33 West Vista Drive, Holbrook, AZ 86025-1844 | 2015-01-08 |
| 1356739650 | Prescott Vamc | Clinic/Center | 801 North Navajo Drive, Suite B, Page, AZ 86040-9998 | 2015-01-08 |
| 1265785364 | Phoenix Vamc | Clinic/Center | 11390 East Via Linda Road, Suite 105, Scottsdale, AZ 85259-4075 | 2012-10-26 |
| 1952345076 | Prescott Vamc | Clinic/Center | 1300 W University Ave, #200, Flagstaff, AZ 86001-7214 | 2006-06-16 |
| 1235173931 | Tucson Vamc | Clinic/Center | 101 N Coronado Dr Ste A, Building 45006, Sierra Vista, AZ 85635-6359 | 2006-06-15 |
| 1649219528 | Tucson Vamc | Clinic/Center | 3111 S 4th Ave, Yuma, AZ 85364-8122 | 2006-06-06 |
| 1437197902 | Phoenix Vamc | Clinic/Center | 3285 S Val Vista Dr, Gilbert, AZ 85297-7000 | 2006-06-04 |
| 1902844632 | Tucson Vamc | Clinic/Center | 355 North 8th Avenue, Safford, AZ 85546-2694 | 2006-06-03 |
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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.