Carol Jane Vanderzwaag, M.D

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

34487 Issued in NC

Practice address

5509 Creedmoor Rd
Raleigh, NC 27612-6312

Phone

(919) 573-6520

Fax

(919) 573-6555

NPI assigned

May 4, 2009

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southlight Healthcare

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1316268345
  Medicare reassignment NPD
• Southlight Healthcare

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1932300019
  NPD

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1215161492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5509 CREEDMOOR RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126312",
            "telephone_number": "919-573-6520",
            "fax_number": "919-573-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5509 CREEDMOOR RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276126312",
            "telephone_number": "919-573-6520",
            "fax_number": "919-573-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERZWAAG",
        "first_name": "CAROL",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-04",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "34487",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5901986",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Vance, LCMHCA
• Lindsay Vandenbroeck
• Olivia Vanderhoff, LCASA
• Carin Michelle Vanderklok, DVM
• Trisha Noel Vanderploeg, PNP
• Dylan Shane Vandiver
• Jeffrey Allen Vanfleet, OTR/L
• Jordan C Vanhook
• Vanilla Care ABA Therapy LLC
• Reed Matthew Vanmatre, MD

• Psychiatry Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.