FAYETTEVILLE VAMC (NPI# 1912952235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912952235 |
| Entity Type | Organization |
| Organization Name | FAYETTEVILLE VAMC |
| Other Organization Name | HARRISON VA CLINIC |
| Practice Address |
814 Highway 62 65 N Ste 8 Harrison AR 72601-2149 |
| Mailing Address |
Po Box 94494 Cleveland OH 44101 |
| Practice Telephone | 6153553451 |
| Mailing Telephone | 6153553451 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2019-07-09 |
| 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 |
|---|---|
| Harrison VA CBOC | Other Name - Individual/Organization |
| HARRISON VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992264824 | Fayetteville Vamc | Clinic/Center | 3015 Connecticut Ave, Joplin, MO 64804-3035 | 2019-03-19 |
| 1659879138 | Fayetteville Vamc | Clinic/Center | 4 Josh Ct, Jacksonville, NC 28546-0052 | 2018-01-30 |
| 1194256362 | Fayetteville Vamc | Clinic/Center | 4101 Raeford Road, Suite 100-b, Fayetteville, NC 28304-4114 | 2017-03-21 |
| 1528456811 | Fayetteville Vamc | Clinic/Center | 216 East Township Street, Fayetteville, AR 72703-2818 | 2015-01-08 |
| 1124422308 | Fayetteville Vamc | Clinic/Center | 306 Brynn Marr Rd, Jacksonville, NC 28546-7023 | 2014-10-16 |
| 1962819052 | Fayetteville Vamc | Clinic/Center | 18 Doctors Cir Ste 2, Supply, NC 28462-4089 | 2014-07-21 |
| 1114270212 | Fayetteville Vamc | Clinic/Center | 3112 Tramway Road, Sanford, NC 27332-9998 | 2012-10-26 |
| 1912201146 | Fayetteville Vamc | Clinic/Center | 139 Three Hunts Drive, Pembroke, NC 28372-6800 | 2011-01-03 |
| 1831415751 | Fayetteville Vamc | Clinic/Center | 2713 W Commercial St, Ozark, AR 72949-3409 | 2010-04-16 |
| 1568417798 | Fayetteville Vamc | Clinic/Center | 4006 Henderson Drive, Jacksonville, NC 28546-9998 | 2006-05-24 |
| Street Address |
814 HIGHWAY 62 65 N STE 8 |
| City | HARRISON |
| State | AR |
| Zip Code | 72601-2149 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730146788 | Michael Phillip Souter | Family Medicine | 814 Highway 62 65 N Ste 8, Harrison, AR 72601-2149 | 2006-04-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184280364 | Linda Marie Balcerak | Physical Therapy Assistant | 400 Hwy 43 East, Harrison, AR 72601 | 2019-05-14 |
| 1750847315 | Boston Mountain Rural Health Center Inc. | Clinic/Center | 1002 North Spring St., Harrison, AR 72601 | 2019-02-19 |
| 1154808236 | Carrie Lynn Miller | Midwife | 5977 Sulphur. Mt. Rd, Harrison, AR 72601 | 2018-07-23 |
| 1255833778 | Julie Foster, Speech Language Pathologist, Inc. | Speech-Language Pathologist | 1898 Foley Rd, Harrison, AR 72601 | 2018-02-28 |
| 1386163582 | Reagan Brittany Kenney | Case Manager/Care Coordinator | 4537 Meadow Wood Lane, Harrison, AR 72601 | 2017-09-19 |
| 1306394465 | Rebecca Jane Mcanulty | Nurse Practitioner | 702 N. Springs Street, Harrison, AR 72601 | 2016-09-19 |
| 1194174763 | Jessalyn Foy | Case Manager/Care Coordinator | 413 N Rowland St, Harrison, AR 72601 | 2016-06-06 |
| 1689022311 | Eva Laynette Norris | Case Manager/Care Coordinator | 114 E. Crandall, Harrison, AR 72601 | 2016-06-03 |
| 1760830491 | Jana Daniels | Case Manager/Care Coordinator | 9378a Hwy 7 North, Harrison, AR 72601 | 2016-06-03 |
| 1376992016 | Laken Nichole Curtis | Case Manager/Care Coordinator | 5985 James Phifer Ln, Harrison, AR 72601 | 2016-06-03 |
| Find all providers in zip 72601 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528456811 | Fayetteville Vamc | Clinic/Center | 216 East Township Street, Fayetteville, AR 72703-2818 | 2015-01-08 |
| 1073821518 | Little Rock Vamc | Clinic/Center | 1520 E Dave Ward Dr, Conway, AR 72032-9649 | 2010-09-17 |
| 1831415751 | Fayetteville Vamc | Clinic/Center | 2713 W Commercial St, Ozark, AR 72949-3409 | 2010-04-16 |
| 1649401316 | Memphis Vamc | Clinic/Center | 125 Quarles Ln, West Helena, AR 72390-1923 | 2009-07-29 |
| 1508809948 | St. Louis Jc Vamc | Clinic/Center | 2420 Linwood Dr, Suite 3, Paragould, AR 72450-6122 | 2006-06-14 |
| 1417996489 | Shreveport Vamc | Clinic/Center | 910 Realtor Road, Texarkana, AR 71854-1020 | 2006-06-05 |
| 1063450617 | Little Rock Vamc | Clinic/Center | 759 Highway 62 E, Suite 331, Mountain Home, AR 72653-3260 | 2006-06-04 |
| 1861439697 | Little Rock Vamc | Clinic/Center | 300 Morrow St S, Mena, AR 71953 | 2006-06-01 |
| 1619923398 | Memphis Vamc | Clinic/Center | 2908 S Caraway Rd Ste B, Jonesboro, AR 72401-7306 | 2006-05-25 |
| 1215982582 | Little Rock Vamc | Clinic/Center | 177 Sawtooth Oak St, Hot Springs, AR 71901-7160 | 2006-05-24 |
| 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.