NPIMap

Individual provider Active NPI

Ronald Vandernoord, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Matthews, NC
National Provider Identifier
1083696892
Registry record updated Mar 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X
License
2001-00620 Issued in NC
Practice address
710 Park Center Dr Ste 300
Matthews, NC 28105-5082
Phone
(704) 323-2000
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X 2001-00620 NC Primary

Addresses

Primary practice location

710 Park Center Dr Ste 300
Matthews, NC 28105-5082

Mailing address

4601 Park Rd
Ste 300
Charlotte, NC 28209-3239
Phone (704) 323-2000

Other identifiers 2

IdentifierTypeStateIssuer
89129TNMedicaidNC
N00620MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040206000326 NC Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 6406749001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Medical College of Georgia School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
OrthocarolinaGroup PAC ID 2062316821, 288 clinicians

Practice addresses (Care Compare)

710 Park Ctr Dr
Matthews, NC 28105-5081
Phone (704) 323-3200

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthocarolina Pain Medicine CurrentSince Aug 1, 2001 Accepting new patients
Orthocarolina, PA CurrentSince Aug 1, 2001 Accepting new patients
Orthocarolina Current Accepting new patients
Fort Wayne Orthopaedics, LLC Past Accepting new patients
Fort Wayne Orthopaedics LLC Past Accepting new patients

Locations

1915 Randolph Rd
Charlotte, NC 28207
Phone (704) 339-1000

4601 Park Rd
Ste 300
Charlotte, NC 28209
Phone (704) 323-2090

710 Park Center Dr
Ste 300
Matthews, NC 28105
Phone (704) 323-3200

710 Park Center Dr
Matthews, NC 28105
Phone (704) 323-3208

703 Comfort Ln
Monroe, NC 28112
Phone (704) 226-9550

Organizations & group practices 5

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 7

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521504000000",
    "number": "1083696892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 PARK RD",
            "address_2": "STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093239",
            "telephone_number": "704-323-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 PARK CENTER DR STE 300",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055082",
            "telephone_number": "704-323-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERNOORD",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2018-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NC",
            "license": "2001-00620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89129TN",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "N00620",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

Verify at the official NPI Registry.