V.A. MEDICAL CENTER (NPI# 1952744336) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952744336 |
| Entity Type | Organization |
| Organization Name | V.A. MEDICAL CENTER |
| Practice Address |
1500 E Woodrow Wilson Ave Jackson MS 39216-5116 |
| Practice Telephone | 6013624471 |
| Mailing Telephone | 6013624471 |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2013-04-16 |
| Authorized Official Name | MR. JOHNNY SMITH (RESPIRATORY THERAPIST) |
| Authorized Official Telephone | 6013624471 |
| Authorized Official Credential | RRT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 284300000X | Special Hospital | Hospitals |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | V A MEDICAL CENTER | 1501 San Pedro Drive Se, Albuquerque, NM 87108-5153 |
| 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 |
| System for Award Management (SAM) Entities | VA PROVIDENCE MEDICAL CENTER | 830 Chalkstone Ave, Providence, RI 02908-4734 |
| System for Award Management (SAM) Entities | VALLEY HOSPITAL MEDICAL CENTER | 620 Shadow Ln, Las Vegas, NV 89106-4119 |
| System for Award Management (SAM) Entities | VALLEY HOSPITAL MEDICAL CENTER, INC. | 620 Shadow Ln, Las Vegas, NV 89106-4119 |
| System for Award Management (SAM) Entities | VALLEY MEDICAL CENTER | 400 S 43rd St, Renton, WA 98055-5714 |
| System for Award Management (SAM) Entities | VALLEY OF HOPE HOLISTIC MEDICAL CENTER | 2100 45th St Ste B23, West Palm Beach, FL 33407-2070 |
| Washington State Corporations | VALLEY VILLAGE MEDICAL CENTER MANAGER, LLC | 20687 Amar Rd Ste 2-789, Walnut, CA 91789-5044 |
| Oregon Corporations, Companies and Business Names | VALLEY VILLAGE MEDICAL CENTER MANAGER, LLC | 20687 Amar Road Ste 2-789, Walnut, CA 91789 |
| Street Address |
1500 E WOODROW WILSON AVE |
| City | JACKSON |
| State | MS |
| Zip Code | 39216-5116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740264035 | Sadeka Tamanna | Internal Medicine | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2005-12-01 |
| 1881291383 | Regina Marie Riley | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-10-07 |
| 1811502024 | Wendy Hopkins | Registered Nurse | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-09-14 |
| 1528679420 | Christopher Michael Mcguffey | Physical Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-08-13 |
| 1124637319 | Kathryn Martin Lewis | Registered Nurse | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-24 |
| 1932727468 | Davis Mckenna Simms | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-10 |
| 1154948222 | Tiffany Floyd | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-06 |
| 1962029389 | Devonda Y Elliott | Recreation Therapist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-07-01 |
| 1629693759 | Latorya Lashay Smith | Dietitian, Registered | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-06-15 |
| 1932721669 | Aubrey Cain Young | Pharmacist | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2020-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| Taxonomy Code | 284300000X |
| Grouping | Hospitals |
| Classification | Special Hospital |
| A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. |
| Notes: Source: AHA Guide, Registration section, p. A5. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851730121 | Sonny Montgomer Vamc | Special Hospital | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2013-06-20 |
| 1740623768 | Department of Veterans Affairs | Special Hospital | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2013-04-09 |
| 1447465067 | Univ Prev Med Assocs Pllc | Special Hospital | 2500 N State St, Jackson, MS 39216-4500 | 2007-05-14 |
| 1023104106 | Harvey William Marcellus | Special Hospital | 1500 E Woodrow Wilson Ave, Jackson, MS 39216-5116 | 2006-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902060825 | Veterans Healthcare Administration | Special Hospital | 400 Veterans Ave, 11ecp Hbpc, Biloxi, MS 39531-2410 | 2008-07-10 |
| 1366533093 | Tri Lakes Medical Center | Special Hospital | 303 Medical Center Dr, Batesville, MS 38606-8608 | 2006-09-27 |
| 1255364477 | Gulf Coast Vamc | Special Hospital | 400 Veterans Ave, Biloxi, MS 39531-2410 | 2006-07-09 |
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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.