MOUNTAIN HOME VAMC (NPI# 1982236907) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982236907 |
| Entity Type | Organization |
| Organization Name | MOUNTAIN HOME VAMC |
| Practice Address |
500 Washington Ave Johnson City TN 37604-5518 |
| Mailing Address |
Po Box 94516 Cleveland OH 44101-4516 |
| Practice Telephone | 6153553451 |
| Mailing Telephone | 6153553451 |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-07 |
| Authorized Official Name | ERIN DENISE POTTER (NPI LEAD) |
| 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 |
|---|---|
| JOHNSON CITY VA CLINIC | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922544394 | Mountain Home Vamc | Clinic/Center | 1521 Downtown West Blvd, Knoxville, TN 37919-5407 | 2017-01-10 |
| 1316335680 | Mountain Home Vamc | Clinic/Center | 32613 Wilderness Road, Suite 101, Jonesville, VA 24263-9998 | 2015-01-08 |
| 1497143531 | Mountain Home Vamc | Clinic/Center | 4451 Lee Highway, Marion, VA 24354-9998 | 2014-12-23 |
| 1306234448 | Mountain Home Vamc | Clinic/Center | 1941 Lover's Gap Lane, Suite A, Vansant, VA 24656-9998 | 2014-12-23 |
| 1639342231 | Mountain Home Vamc | Clinic/Center | 925 E Morris Blvd, Morristown, TN 37813-2499 | 2008-04-04 |
| 1700824646 | Mountain Home Vamc | Clinic/Center | 401 Scenic Dr, Rogersville, TN 37857-2452 | 2006-06-03 |
| 1841237385 | Mountain Home Vamc | Clinic/Center | 654 Highway 58 E, Norton, VA 24273-3002 | 2006-06-01 |
| 1831148253 | Mountain Home Vamc | General Acute Care Hospital | Sidney and Lamont Streets, Mountain Home, TN 37684-4000 | 2006-05-10 |
| 1548218266 | Mountain Home Vamc | Department of Veterans Affairs (VA) Pharmacy | 1141 Cold Springs Rd, Mountain City, TN 37683-4032 | 2006-05-05 |
| 1053942474 | Mountain Home Vamc | Clinic/Center | 1141 Cold Springs Rd, Mountain City, TN 37683-4032 | 2020-02-04 |
| Street Address |
500 WASHINGTON AVE |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604-5518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417560707 | Brant Logan Nickens | Physical Therapist | 809 Lamont St and Veterans Way, Johnson City, TN 37604 | 2020-08-26 |
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 261QV0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | VA |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922544394 | Mountain Home Vamc | Clinic/Center | 1521 Downtown West Blvd, Knoxville, TN 37919-5407 | 2017-01-10 |
| 1073060133 | Nashville Vamc | Clinic/Center | 2 International Plaza Drive, Suite 300, Nashville, TN 37217-2011 | 2016-09-07 |
| 1962958256 | Nashville Vamc | Clinic/Center | 1208 Pointe Centre Drive, Chattanooga, TN 37421-3989 | 2016-08-28 |
| 1750779898 | Nashville Vamc | Clinic/Center | 1919 Charlotte Avenue, Suite 100, Nashville, TN 37203-2219 | 2014-12-23 |
| 1316267743 | Nashville Vamc | Clinic/Center | 2305 N Gateway Ave, Suite 2, Harriman, TN 37748-8665 | 2010-06-08 |
| 1205072436 | Memphis Vamc | Clinic/Center | 180 Old Hickory Blvd, Suite A, Jackson, TN 38305-2562 | 2008-12-17 |
| 1639342231 | Mountain Home Vamc | Clinic/Center | 925 E Morris Blvd, Morristown, TN 37813-2499 | 2008-04-04 |
| 1326082546 | Nashville Vamc | Clinic/Center | 225 Von Karman Road, Arnold Air Force Base, TN 37389-9998 | 2006-06-16 |
| 1700824646 | Mountain Home Vamc | Clinic/Center | 401 Scenic Dr, Rogersville, TN 37857-2452 | 2006-06-03 |
| 1669427050 | Memphis Vamc | Clinic/Center | 70 Harbert Dr, Savannah, TN 38372-2333 | 2006-05-23 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on MOUNTAIN HOME VAMC.
| 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.