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TUPELO VA CBOC
NPI 1073552436
Clinic/Center - VA in Tupelo, MS

Active since June 04, 2006CLIA 25D2101589 · Waiver
1114 COMMONWEALTH BLVD., TUPELO, MS 38804(615) 355-3451 Get Directions Write a Review

NPPES record last updated: September 13, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tupelo Va Cboc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TUPELO VA CBOC (NPI 1073552436) is a healthcare organization registered as a va in Tupelo, Mississippi and active in the NPI registry since June 2006. The organization holds a CLIA Waiver certificate valid through September 3, 2027 and lists Erin Potter, Npi Team Member, as its authorized official.

NPPES Registry Identity

NPI1073552436
Entity TypeOrganization
Primary Taxonomy261QV0200X
Legal Business NameMEMPHIS VAMC
Location Address1114 COMMONWEALTH BLVD.Tupelo, MS 38804-9998
Mailing AddressPo Box 94511Cleveland, OH 44101 · (615) 355-3451
Phone(615) 355-3451
Organization SubpartNo
Authorized OfficialErin PotterNpi Team Member · (202) 382-2579
Enumeration DateJune 4, 2006
Last NPPES UpdateSeptember 13, 2017
✔ NPI 1073552436 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · VAAmbulatory Health Care Facilities
Taxonomy Code261QV0200X
1114 COMMONWEALTH BLVD., Tupelo, MS 38804
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Other Names 1

Other NameTupelo Va Cboc

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D2101589

Tupelo VA Clinic · Tupelo, MS
Active · expires Sep 3, 2027
CLIA Number25D2101589
Laboratory TypePhysician Office
Certificate Effective DateSeptember 4, 2025
Certificate Expiration DateSeptember 3, 2027
Laboratory DirectorJo A. Harrison
Laboratory Phone(662) 840-6366
Laboratory LocationTupelo VA Clinic1114 Commonwealth Blvd, Tupelo, MS 38804
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Memphis Vamc's NPI number?

The NPI number for Memphis Vamc is 1073552436. It was assigned to this organization in the NPPES registry on June 4, 2006. The provider is also known as Tupelo VA Cboc.

Where is Memphis Vamc located?

Memphis Vamc is located at 1114 Commonwealth Blvd., Tupelo, MS 38804. The listed phone number is (615) 355-3451.

What is Memphis Vamc's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in VA, with taxonomy code 261QV0200X.

Does Memphis Vamc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D2101589) is associated with this NPI, valid through September 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Memphis Vamc was last updated on September 13, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.