Cortney A Vandenburgh, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

O0419 Issued in ID

Practice address

1450 Aviation Dr
Suite 100
Hailey, ID 83333-8785

Phone

(208) 788-3434

Fax

(208) 788-2025

NPI assigned

Jun 21, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Cortney Ann Gilbertson Former name

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Kansas City College of Medicine and Surgery, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Lukes Clinic - Wood River LLCGroup PAC ID 3173783818, 66 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Luke'S Wood River Medical Center Hospital, Ketchum, ID, CCN 131323
• St Lukes Magic Valley Medical Center Hospital, Twin Falls, ID, CCN 130002
• St Luke'S Regional Medical Center Hospital, Boise, ID, CCN 130006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cvandenburgh17055@direct.slhs.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Lukes Clinic - Wood River LLC

  • Internal Medicine Physician
  • Ketchum, ID
  • NPI 1972891604

  Family Medicine

  Medicare reassignment Care Compare group NPD
• St Luke'S Clinic LLC

  • Family Medicine Physician
  • Twin Falls, ID
  • NPI 1790718229
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St Lukes Regional Medical Center

  • Ambulance
  • Boise, ID
  • NPI 1518115195

  Hospital

  Care Compare affiliation
• St Lukes Regional Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  Care Compare affiliation
• St Lukes Wood River Medical Center LTD

  • Critical Access Hospital
  • Ketchum, ID
  • NPI 1508869470
  Care Compare affiliation
• St. Luke'S Magic Valley Regional Medical Center, LTD.

  • General Acute Care Hospital
  • Twin Falls, ID
  • NPI 1932154705
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1003852849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-381-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 AVIATION DR",
            "address_2": "SUITE 100",
            "city": "HAILEY",
            "state": "ID",
            "postal_code": "833338785",
            "telephone_number": "208-788-3434",
            "fax_number": "208-788-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBURGH",
        "first_name": "CORTNEY",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "O0419",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "MR0827",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807191900",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCRR",
            "identifier": "P00721168",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CORTNEY",
            "last_name": "GILBERTSON",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cynda L Tomlinson, M.D.
• Jamie Truppi, MSN, CNS
• Two Rivers Family & Cosmetic Dentistry, PA
• Cynthia Kay Unger, DDS
• Jean Anne Vandenberg
• Amber Vanderbeek, LCSW
• Gwendolyn Ann Vandooren, D.C.
• Verst Spine & Orthopedic Care,PLLC
• David Bernard Verst, MD
• Carol A Wade, R.N.,C.S.,F.N.P.

• Family Medicine Physician in Hailey, ID
• Providers in Hailey, ID by specialty
• Family Medicine Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.