Individual provider Active NPI

Cheryl L Vandewege

  • Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1093183006
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704159114 Issued in MI
Practice address
1915 White Ave
Knoxville, TN 37916-2300
Phone
(865) 331-1720
Fax
(865) 331-2823
NPI assigned
Sep 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 4704159114 MI Primary

Addresses

Primary practice location

1915 White Ave
Knoxville, TN 37916-2300

Mailing address

1915 White Ave
Knoxville, TN 37916-2300
Phone (865) 331-1720

Other identifiers 1

IdentifierTypeStateIssuer
Q071411MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address vandewege.cheryl@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220218000124 TN Practitioner - Nurse Practitioner 1153626882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thompson Oncology GroupGroup PAC ID 0941246771, 65 clinicians

Practice addresses (Care Compare)

1915 White Ave
Knoxville, TN 37916-2300
Phone (865) 541-1720

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704159114MIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thompson Oncology Group CurrentSince Dec 13, 2021 Accepting new patients

Locations

Dept 888078
Knoxville, TN 37995

1915 White Ave
Knoxville, TN 37916
Phone (423) 977-1065

200 New York Ave
Oak Ridge, TN 37830
Phone (865) 483-7511

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 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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1093183006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 WHITE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162300",
            "telephone_number": "865-331-1720",
            "fax_number": "865-331-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 WHITE AVE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162300",
            "telephone_number": "865-331-1720",
            "fax_number": "865-331-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEWEGE",
        "first_name": "CHERYL",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704159114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q071411",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vandewege.cheryl@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1915 White Ave",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379162300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.