Individual provider Active NPI

Victoria Vanderaa, M.S., CCC-SLP/L

  • Speech-Language Pathologist
  • Nashville, TN
National Provider Identifier
1063967479
Registry record updated Jun 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7687 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232-3360
Phone
(615) 322-5000
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 242.004100 IL
Speech-Language Pathologist 235Z00000X 7687 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232-3360

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691

Other practice location 1

1215 21st Ave S Ste 6209
Nashville, TN 37232-3360
Phone (615) 936-5000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vvanderaa656861@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IL, CA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230809004144 TN Practitioner - Qualified Speech Language Pathologist 3870955735 Reassigns benefits to 1 organization
I20240513000248 IL Practitioner - Qualified Speech Language Pathologist 3870955735 Reassigns benefits to 1 organization
I20240604004190 CA Practitioner - Qualified Speech Language Pathologist 3870955735 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Expressable Speech-Language Pathology PCGroup PAC ID 4688074511, 115 clinicians

Practice addresses (Care Compare)

5 Revere Dr
Northbrook, IL 60062-1566
Phone (512) 399-0064

633 W 5TH St
Ofc 2876B
Los Angeles, CA 90071-2005
Phone (512) 399-0064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
242.004100ILMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Expressable Therapy PC Speech-Language Pathologist CurrentSince May 20, 2024 Accepting new patients
Expressable Speech-Language Pathology, P.C. Speech-Language Pathologist CurrentSince May 20, 2024 Accepting new patients

Locations

633 W 5th St
Los Angeles, CA 90071
Phone (213) 260-1286

633 W 5th St
Ofc 2876B
Los Angeles, CA 90071

5 Revere Dr
#One
Northbrook, IL 60062

5 Revere Dr
Ste 200
Northbrook, IL 60062
Phone (630) 291-3206

40 Burton Hills Blvd
Ste 200
Nashville, TN 37215
Phone (615) 257-8410

7600 Chevy Chase Dr
Ste 300
Austin, TX 78752
Phone (512) 318-2503

Interoperability endpoints

  • Direct secure messaging: vvanderaa656861@direct.vumc.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686096000000",
    "number": "1063967479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372323360",
            "telephone_number": "615-322-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 21st Ave S Ste 6209",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372323360",
            "country_code": "US",
            "telephone_number": "615-936-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERAA",
        "first_name": "VICTORIA",
        "credential": "M.S., CCC-SLP/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2023-06-07",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.004100",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "7687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vvanderaa656861@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "1215 21st Ave S Ste 6209",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "372323360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.