Kandise J Vandyne Pmhnp

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

77982 Issued in NM

Practice address

1105 Memorial Dr
Artesia, NM 88210-1189

Phone

(575) 746-9848

NPI assigned

Jul 30, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Presbyterian Medical ServicesGroup PAC ID 2062324684, 132 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kandise.vandyne.p1@direct.pmsnm.nextgenshare.com

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.

• Presbyterian Medical Services

  • Federally Qualified Health Center (FQHC)
  • Rio Rancho, NM
  • NPI 1871505032
  Medicare reassignment Care Compare group NPD
• Presbyterian Medical Services

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1306654462
  NPD
• Presbyterian Medical Services

  • Federally Qualified Health Center (FQHC)
  • Alamogordo, NM
  • NPI 1821341488
  NPD

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725840000000",
    "number": "1104655893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 MEMORIAL DR",
            "city": "ARTESIA",
            "state": "NM",
            "postal_code": "882101189",
            "telephone_number": "970-623-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 MEMORIAL DR",
            "city": "ARTESIA",
            "state": "NM",
            "postal_code": "882101189",
            "telephone_number": "575-746-9848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "914 N Canal St",
            "address_purpose": "LOCATION",
            "city": "Carlsbad",
            "state": "NM",
            "postal_code": "882205110",
            "country_code": "US",
            "telephone_number": "575-885-4836",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDYNE PMHNP",
        "first_name": "KANDISE",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-09-09",
        "certification_date": "2024-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "77982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deisy Natali Trevizo
• Susan Emelie Trompeter, M.D.
• Jennifer Anne Tupper, DNP, APRN, FNP-BC
• Turquoise Health and Wellness, Inc.
• Mayra Urban, LSWB
• Aaron Samuel Vega, PA
• Vashti Nicole Venegas, RN
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Karen Renee Waldrip, PHARMD

• Psychiatric/Mental Health Nurse Practitioner in Artesia, NM
• Providers in Artesia, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.