Individual provider Active NPI

Beth Ann Vanderpool, PA

  • Physician Assistant
  • Killeen, TX
National Provider Identifier
1285718213
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
5320 E Central Texas Expy Ste 105
Killeen, TX 76543-5516
Phone
(254) 519-1900
Fax
(254) 519-1980
NPI assigned
Oct 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

5320 E Central Texas Expy Ste 105
Killeen, TX 76543-5516

Mailing address

5320 E Central Texas Expy Ste 105
Killeen, TX 76543-5516
Phone (254) 519-1900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150826001640 TX Practitioner - Physician Assistant 1951577691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William S Marsh III, DO, PAGroup PAC ID 6901894245, 3 clinicians

Practice addresses (Care Compare)

5320 E Central Texas Expy
Suite 105
Killeen, TX 76543-5516
Phone (254) 519-1900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2565COMDClinical Psychologist

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1285718213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5320 E CENTRAL TEXAS EXPY STE 105",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435516",
            "telephone_number": "254-519-1900",
            "fax_number": "254-519-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 E CENTRAL TEXAS EXPY STE 105",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765435516",
            "telephone_number": "254-519-1900",
            "fax_number": "254-519-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERPOOL",
        "first_name": "BETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

Verify at the official NPI Registry.