Jamie Vandermierden

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2019019067 Issued in MO

Practice address

1723 Broadway St Ste 210
Cape Girardeau, MO 63701-4556

Phone

(573) 331-7870

Fax

(573) 331-7899

NPI assigned

Jun 10, 2019

Sex

Female

Sole proprietor

Yes

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 MO

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Missouri Hospital Physicians LLCGroup PAC ID 9133024334, 206 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital Southeast Hospital, Cape Girardeau, MO, CCN 260110
• Mercy Hospital Stoddard Hospital, Dexter, MO, CCN 260160
• Mercy Hospital Perry Hospital, Perryville, MO, CCN 261311

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Southeast Missouri Hospital Physicians, LLC

  • Family Medicine Physician
  • Cape Girardeau, MO
  • NPI 1558311522
  Medicare reassignment Care Compare group NPD

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

• Mercy Hospital Perry

  • Critical Access Hospital
  • Perryville, MO
  • NPI 1063117158
  Care Compare affiliation
• Southeast Health Center of Stoddard County, LLC

  • General Acute Care Hospital
  • Dexter, MO
  • NPI 1801990825
  Care Compare affiliation
• Southeast Hospital

  • General Acute Care Hospital
  • Cape Girardeau, MO
  • NPI 1811006661
  Care Compare affiliation

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1487213864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST STE 210",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014556",
            "telephone_number": "573-331-7870",
            "fax_number": "573-331-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1723 BROADWAY ST STE 210",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637014556",
            "telephone_number": "573-331-7870",
            "fax_number": "573-331-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMIERDEN",
        "first_name": "JAMIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2019019067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista N Valentine, PTA
• Joanna Vamplew, PHARMD
• Andrea S Van Horn
• Cheri A Vance
• Keith W Vancuran, MD
• Autumn Rose Vangennip, RDH
• Sydney Justine Vangennip, MSN, APRN, FNP-C
• Torie Nicole Vanpool, M.A, P.L.P.C
• James Vanpopering, D.O.
• Brianna Renay Vanvickle

• Family Nurse Practitioner in Cape Girardeau, MO
• Providers in Cape Girardeau, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.