Organization Active NPI

VB Medical Group

  • Family Nurse Practitioner
  • Jeffersonville, IN
National Provider Identifier
1285234237
Registry record updated Nov 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
VB MEDICAL GROUP
Practice address
111 Quartermaster CT
Jeffersonville, IN 47130-3627
Phone
(812) 920-3005
Fax
(866) 554-1805
NPI assigned
Oct 29, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2021

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

Authorized official

Name
Vanessa Sims, APRN-CNPI 1124431382
Title
President & Manager
Phone
(812) 920-3005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

111 Quartermaster CT
Jeffersonville, IN 47130-3627

Mailing address

111 Quartermaster CT
Jeffersonville, IN 47130-3627
Phone (812) 920-3005

Other identifiers 1

IdentifierTypeStateIssuer
300049921MedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210513000685 IN Part B Supplier - Clinic/Group Practice 5193134666 Receives reassigned benefits from 5 practitioners
Practice locations: Jeffersonville, IN

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2256579VB Medical Group111 Quartermaster Court, Jeffersonville, IN 47130Certificate of waiverMar 24, 2028

National Provider Directory

National Provider Directory

Locations

111 Quartermaster Ct
Jeffersonvlle, IN 47130
Phone (812) 920-3005

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636502400000",
    "number": "1285234237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 QUARTERMASTER CT",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303627",
            "telephone_number": "812-920-3005",
            "fax_number": "866-554-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 QUARTERMASTER CT",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471303627",
            "telephone_number": "812-920-3005",
            "fax_number": "866-554-1805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VB MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-29",
        "last_updated": "2021-11-10",
        "certification_date": "2021-11-10",
        "status": "A",
        "authorized_official_last_name": "SIMS",
        "authorized_official_first_name": "VANESSA",
        "authorized_official_title_or_position": "PRESIDENT & MANAGER",
        "authorized_official_telephone_number": "812-920-3005",
        "authorized_official_credential": "APRN-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300049921",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jeffersonville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.