Individual provider Active NPI

Christopher Johannus Vandermeer, MD

  • Diagnostic Radiology Physician
  • Gastonia, NC
National Provider Identifier
1063495117
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
200101148 Issued in NC
Practice address
620 Summit Crossing PL
Ste 106
Gastonia, NC 28054
Phone
(704) 867-8021
Fax
(704) 864-4606
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X 200101148 NC
Diagnostic Radiology Physician 2085R0202X 200101148 NC Primary

Addresses

Primary practice location

620 Summit Crossing PL
Ste 106
Gastonia, NC 28054

Mailing address

620 Summit Crossing PL
Ste 106
Gastonia, NC 28054
Phone (704) 867-8021

Other identifiers 9

IdentifierTypeStateIssuer
137Y2OtherBLUE CROSS BLUE SHIELD
560988142OtherUNITED HEALTHCARE
P00192298OtherRAILROAD MEDICARE
8913742MedicaidNC
804854OtherPARTNERS
7239629OtherAETNA PPO
N01141MedicaidSC
D4992OtherMEDCOST
3616235OtherAETNA HMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20040907001314 NC Practitioner - Diagnostic Radiology 3476529850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Virginia Commonwealth University, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gaston Radiology PAGroup PAC ID 4082680806, 29 clinicians

Practice addresses (Care Compare)

620 Summit Crossing Place
Suite 106
Gastonia, NC 28054-2176
Phone (704) 864-4378

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
200101148NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Radiology PA Diagnostic Radiology CurrentSince Jul 12, 2004 Accepting new patients
Gaston Radiology Diagnostic Radiology Current Accepting new patients

Locations

1212 Spruce St
Belmont, NC 28012
Phone (704) 825-5677

2525 Court Dr
Gastonia, NC 28054
Phone (704) 834-2662

336 Burtonwood Dr
Gastonia, NC 28054
Phone (704) 867-8021

620 Summit Crossing Pl
Ste 106
Gastonia, NC 28054
Phone (704) 864-4378

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215648000000",
    "number": "1063495117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SUMMIT CROSSING PL",
            "address_2": "STE 106",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-867-8021",
            "fax_number": "704-864-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SUMMIT CROSSING PL",
            "address_2": "STE 106",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "28054",
            "telephone_number": "704-867-8021",
            "fax_number": "704-864-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMEER",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHANNUS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2008-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "NC",
            "license": "200101148",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200101148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "137Y2",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "560988142",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00192298",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913742",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "804854",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7239629",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N01141",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "D4992",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3616235",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.