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JACK C. MONTGOMERY VA MEDICAL CENTER
NPI 1891682753
Nursing Care in Muskogee, OK

Active since June 23, 2025CLIA 37D0987997 · Accreditation
1011 HONOR HEIGHTS DR, MUSKOGEE, OK 74401(918) 577-3551 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jack C. Montgomery Va Medical Center NPPES

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

JACK C. MONTGOMERY VA MEDICAL CENTER (NPI 1891682753) is a healthcare organization registered as a nursing care in Muskogee, Oklahoma and active in the NPI registry since June 2025. The organization holds an CLIA Accreditation certificate valid through May 22, 2032 and lists Devin Taylor Trevino, Registered Nurse, as its authorized official.

NPPES Registry Identity

NPI1891682753
Entity TypeOrganization
Primary Taxonomy251J00000X
Legal Business NameJACK C. MONTGOMERY VA MEDICAL CENTER
Location Address1011 HONOR HEIGHTS DRMuskogee, OK 74401-1318
Mailing Address1011 Honor Heights DrMuskogee, OK 74401-1318 · (918) 577-3551
Phone(918) 577-3551
Organization SubpartNo
Authorized OfficialDevin Taylor TrevinoRegistered Nurse · (918) 616-6667
Enumeration DateJune 23, 2025
NPPES CertifiedJune 23, 2025
✔ NPI 1891682753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing CareAgencies
Taxonomy Code251J00000X
Definition
A Nursing Care Agency is an entity that provides skilled nursing care through the services of a Registered Nurse (RN) or a Licensed Practical Nurse (LPN), by employees, contracted individuals, or via a registry, in a variety of settings. The agency may engage in providing private duty nursing and/or staffing services.
1011 HONOR HEIGHTS DR, Muskogee, OK 74401
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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 Accreditation 37D0987997

Jack C Montgomery Vamc · Muskogee, OK
Active · expires May 22, 2032
CLIA Number37D0987997
Laboratory TypeHospital
Certificate Effective DateJune 19, 2001
Certificate Expiration DateMay 22, 2032
Laboratory DirectorZan Ahmed
Laboratory Phone(918) 680-3681
Laboratory LocationJack C Montgomery Vamc1011 Honor Heights Dr Bldg1 2ndfl 2c52, Muskogee, OK 74401
CLIA data matches this NPI record on: Address
This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LESA TRICKETT RRT
Respiratory Therapist, Registered
1011 HONOR HEIGHTS DR
MUSKOGEE, OK 74401
Muskogee County (918) 577-3546
MRS. ALEF NANCY GRAHAM ARNP
Nurse Practitioner (Family)
1011 HONOR HEIGHTS DR
MUSKOGEE, OK 74401
Muskogee County (918) 683-3261
BONNIE M KENNEDY PHARM.D.
Pharmacist
1011 HONOR HEIGHTS DR
MUSKOGEE, OK 74401
Muskogee County (918) 577-3185
BRYAN KEITH SHERMAN
Registered Nurse
1011 HONOR HEIGHTS DR
MUSKOGEE, OK 74401
Muskogee County (405) 830-0503
CHERYL D. CLEVELAND
Registered Nurse (Case Management)
1011 HONOR HEIGHTS DR
MUSKOGEE, OK 74401
Muskogee County (918) 577-3000
LISA LOUISE KIDDIE RN
Registered Nurse (General Practice)
1011 HONOR HEIGHTS DR
MUSKOGEE, OK 74401
Muskogee County (918) 781-3622
DR. VERNON LEE JENKINS D.O.
Emergency Medicine
1011 HONOR HEIGHTS DR
MUSKOGEE, OK 74401
Muskogee County (918) 680-3662
MARIE A ENOW
Registered Nurse
1011 HONOR HEIGHTS DR
MUSKOGEE, OK 74401
Muskogee County (918) 577-4040

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 Jack C. Montgomery VA Medical Center's NPI number?

The NPI number for Jack C. Montgomery VA Medical Center is 1891682753. It was assigned to this organization in the NPPES registry on June 23, 2025.

Where is Jack C. Montgomery VA Medical Center located?

Jack C. Montgomery VA Medical Center is located at 1011 Honor Heights Dr, Muskogee, OK 74401. The listed phone number is (918) 577-3551.

What is Jack C. Montgomery VA Medical Center's specialty?

The primary specialty registered for this NPI is Nursing Care with taxonomy code 251J00000X.

Does Jack C. Montgomery VA Medical Center hold a CLIA laboratory certificate?

Yes. A Certificate of Accreditation (number 37D0987997) is associated with this NPI, valid through May 22, 2032. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Jack C. Montgomery VA Medical Center was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.