Individual provider Active NPI

Nancy Jeanne Vanzile, PH.D.

  • Psychologist
  • Maysville, KY
National Provider Identifier
1073679304
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2007-15 Issued in KY
Practice address
611 Forest Ave
Maysville, KY 41056-1411
Phone
(606) 564-4016
Fax
(606) 564-4016
NPI assigned
Dec 29, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP0319 MN
Psychologist 103T00000X 2007-15 KY Primary

Addresses

Primary practice location

611 Forest Ave
Maysville, KY 41056-1411

Mailing address

611 Forest Ave
Maysville, KY 41056-1411
Phone (606) 564-4016

Other identifiers 1

IdentifierTypeStateIssuer
30608012MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007-15KYMDPsychologist
LP0319MNMDPsychologist
1523KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehend Inc Regional Mental Health- Mental Retardation Board Inc Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1073679304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 FOREST AVE",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410561411",
            "telephone_number": "606-564-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 FOREST AVE",
            "city": "MAYSVILLE",
            "state": "KY",
            "postal_code": "410561411",
            "telephone_number": "606-564-4016",
            "fax_number": "606-564-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANZILE",
        "first_name": "NANCY",
        "middle_name": "JEANNE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0319",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "KY",
            "license": "2007-15",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30608012",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maysville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.