Duane E Vanderslice, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

83-134 Issued in NM

Practice address

816 W Maple St
Farmington, NM 87401-5631

Phone

(505) 327-3634

Fax

(505) 327-2104

NPI assigned

Sep 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226448000000",
    "number": "1407953177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015631",
            "telephone_number": "505-327-3634",
            "fax_number": "505-327-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 W MAPLE ST",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "874015631",
            "telephone_number": "505-327-3634",
            "fax_number": "505-327-2104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERSLICE",
        "first_name": "DUANE",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2008-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NM",
            "license": "83-134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "22095",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "2836",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "850364974",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRESBYTERIAN HEALTH/SALUD",
            "identifier": "201010266",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liilia Van Maanen
• Donald M. Van Sickle Jr., LPCC
• Joshua Lee Vanbuskirk, D.C.
• Kyra Vanden Broeck, DDS
• Kylie Vandenberg
• Michael Ray Vandusen, D.O.
• Joyce Vaughn
• Anthony Patrick Velarde, LSAA
• Pat Velarde
• Caryl Ventura

• Specialist in Farmington, NM
• Providers in Farmington, NM by specialty
• Specialist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.