Beth A. Vandenberg

Primary specialty

Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0808X

License

279388-1 Issued in NY

Practice address

580 Pleasant View Dr
Lancaster, NY 14086-1404

Phone

(716) 685-6730

Fax

(716) 407-0570

NPI assigned

Jun 24, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist

State licenses

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1295761070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 PLEASANT VIEW DR",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140861404",
            "telephone_number": "716-685-6730",
            "fax_number": "716-407-0570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 PLEASANT VIEW DR",
            "city": "LANCASTER",
            "state": "NY",
            "postal_code": "140861404",
            "telephone_number": "716-685-6730",
            "fax_number": "716-407-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "BETH",
        "middle_name": "A.",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0808X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": "NY",
            "license": "279388-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Clinical Nurse Specialist in Lancaster, NY
• Providers in Lancaster, NY by specialty
• Psychiatric/Mental Health Clinical Nurse Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2008; 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.