Robert Vanuden, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

11542 Issued in MS

Practice address

1506 Aston Ave
McComb, MS 39648-2735

Phone

(601) 249-4282

Fax

(601) 249-4852

NPI assigned

Jun 2, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Vicksburg Clinic LLC

  • Infectious Disease Physician
  • Vicksburg, MS
  • NPI 1659307791
  NPD (past)
• Vicksburg Clinic LLC

  • Family Medicine Physician
  • Vicksburg, MS
  • NPI 1790711158
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1245277573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396490490",
            "telephone_number": "601-249-4282",
            "fax_number": "601-249-4852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 ASTON AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482735",
            "telephone_number": "601-249-4282",
            "fax_number": "601-249-4852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANUDEN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RS0010X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sports Medicine",
            "state": "MS",
            "license": "11542",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MS",
            "license": "11542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00095703",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sonya Carol Upton, RD, LD
• Aarti Vadalia, MD
• Van R Simmons DMD PA
• Diane Van, DNP, FNP
• Tresea Vangilder
• Frank Varino Jr.
• Callie Ann Venable, M.S. CCC-SLP
• Stephen Vennum III
• Vibrant Lab Solutions, LLC
• Sherlene Vince, LMSW

• Sports Medicine (Orthopaedic Surgery) Physician in McComb, MS
• Providers in McComb, MS by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.