Active NPI
Kristen Vandyke
- Clinical Social Worker
- Goodlettsville, TN
National Provider Identifier
1245921899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 8479
- Practice address
- 452 Moss TRL Apt A32
Goodlettsville, TN 37072-2067 - Phone
- (423) 802-8171
- NPI assigned
- May 16, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 8479 | TN | Primary |
Addresses
Primary practice location
452 Moss TRL Apt A32
Goodlettsville, TN 37072-2067
Mailing address
452 Moss TRL Apt A32
Goodlettsville, TN 37072-2067
Phone (423) 802-8171
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8479 | TN | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684195200000",
"number": "1245921899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "452 MOSS TRL APT A32",
"city": "GOODLETTSVILLE",
"state": "TN",
"postal_code": "370722067",
"telephone_number": "423-802-8171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "452 MOSS TRL APT A32",
"city": "GOODLETTSVILLE",
"state": "TN",
"postal_code": "370722067",
"telephone_number": "423-802-8171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDYKE",
"first_name": "KRISTEN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-16",
"last_updated": "2023-05-16",
"certification_date": "2023-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "TN",
"license": "8479",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Goodlettsville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.