OrganizationActive
St. Louis Jc Vamc
NPI 1992067995 · VA Clinic/Center · Carbondale, IL
Provider details
- NPI number
- 1992067995
- Entity type
- Organization
- Primary specialty
- VA Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Erin Potter, Npi Team Member(202) 382-2579
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1130 E Walnut St
Suite 100
Carbondale, IL 62901-5007
Phone: (913) 578-4409
Street-level locationGet directions
Mailing address
Po Box 94462
Cleveland, OH 44101-4462
Other names (DBA / former)
- Other name
- Carbondale Va Cboc
Registry dates
- Enumerated
- 2012-06-14
- Last updated
- 2018-01-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.