Edward Jason Vanderburg, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

E4348 Issued in AR

Practice address

6015 Chenonceau Blvd Ste 140
Little Rock, AR 72223-4584

Phone

(501) 868-8410

Fax

(501) 868-8488

NPI assigned

Jul 13, 2006

Last updated

Dec 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Arkansas College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Arkansas Health GroupGroup PAC ID 7911802079, 645 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Home Health-LR Home health agency, Little Rock, AR, CCN 047090
• Baptist Health Medical Center-Little Rock Hospital, Little Rock, AR, CCN 040114
• Baptist Health Rehabilitation Institute Inpatient rehabilitation facility, Little Rock, AR, CCN 043026

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: evanderburg4189@direct.baptist-healthar.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Arkansas Health Group

  dba Baptist Health Family Clinic-West

  • Family Medicine Physician
  • Little Rock, AR
  • NPI 1528323607
  Medicare reassignment Care Compare group NPD
• Arkansas Health Group

  dba Baptist Health Family Clinic Cabot

  • Family Medicine Physician
  • Cabot, AR
  • NPI 1689633448
  Medicare reassignment
• Arcare

  dba ARcare97

  • Federally Qualified Health Center (FQHC)
  • Jacksonville, AR
  • NPI 1821802729
  NPD (past)
• Arkansas Health Group

  dba Baptist Health Family Clinic - White Hall

  • Family Medicine Physician
  • White Hall, AR
  • NPI 1316286149
  NPD (past)

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

• Baptist Health

  dba Baptist Health Medical Center-Little Rock

  • General Acute Care Hospital
  • Little Rock, AR
  • NPI 1043240682
  Care Compare affiliation
• Baptist Health

  dba Baptist Home Health Network

  • Home Health Agency
  • Little Rock, AR
  • NPI 1134225451
  Care Compare affiliation
• Baptist Health

  dba Baptist Health Rehabilitation Institute

  • Rehabilitation Hospital
  • Little Rock, AR
  • NPI 1215967831

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1376568204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 CHENONCEAU BLVD STE 140",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234584",
            "telephone_number": "501-868-8410",
            "fax_number": "501-868-8488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 CHENONCEAU BLVD STE 140",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722234584",
            "telephone_number": "501-868-8410",
            "fax_number": "501-868-8488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBURG",
        "first_name": "EDWARD",
        "middle_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E4348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "162281001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryn Elise Vance, MS
• Mary Kathryn Vance, PHARMD
• Tobias Jay Vancil, MD
• Sandra Brianne Vandenborn, MD
• John Vander Schilden, MD
• Theodora Vanderzalm, MD
• Karin Vanderzee, M.A.
• Robert Julian Vandewalle, M.D.
• Destiny Vandivere
• David Tou Vang, D.C.

• Family Medicine Physician in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.
• 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.