Tania C Vanderbilt, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2193 Issued in SC

Practice address

525 Verdae Blvd Ste 200
Greenville, SC 29607-4021

Phone

(864) 272-0388

Fax

(864) 213-9273

NPI assigned

Feb 18, 2015

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: tania.vanderbilt@tribe513.eclinicaldirectplus.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.

• Grand Strand Pediatrics & Adolescent Medicine, P.a.

  • Pediatric Adolescent Medicine Physician
  • Myrtle Beach, SC
  • NPI 1588614192
  NPD (past)
• University Medical Associates

  • Pediatric Allergy/Immunology Physician
  • Charleston, SC
  • NPI 1902323504
  NPD (past)
• University Medical Associates of the Medical University of South Carol

  • Family Medicine Physician
  • Charleston, SC
  • NPI 1982678496

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1265823876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 DEER TRACK RD",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296814764",
            "telephone_number": "803-467-1446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 VERDAE BLVD STE 200",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296074021",
            "telephone_number": "864-272-0388",
            "fax_number": "864-213-9273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBILT",
        "first_name": "TANIA",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie B. Vance, R.N.
• Lindsey Vance, PA-C
• Michele Vance
• Shasta Dawn Vance, OT
• Taylor Douglas Vance
• Sierra Dawn Vanderkelen, MD
• Sarah Elisabeth Vanderlaan, OTR/L
• Yinet Vanderplow, RBT
• Katelyn Vandevander
• Marianne Elizabeth Vandiver, PHARMD

• Physician Assistant in Greenville, SC
• Providers in Greenville, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.