Individual provider Active NPI

Derek Vanamerongen, M.D.

  • Gynecology Physician
  • Cincinnati, OH
National Provider Identifier
1487849584
Registry record updated Sep 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
35071348 Issued in OH
Practice address
3622 Carpenters Creek Dr
Cincinnati, OH 45241-3822
Phone
(513) 684-7431
NPI assigned
Sep 11, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 35071348 OH Primary

Addresses

Primary practice location

3622 Carpenters Creek Dr
Cincinnati, OH 45241-3822

Mailing address

3622 Carpenters Creek Dr
Cincinnati, OH 45241-3822
Phone (513) 684-7431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35071348OHMDGynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1487849584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3622 CARPENTERS CREEK DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452413822",
            "telephone_number": "513-684-7431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 CARPENTERS CREEK DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452413822",
            "telephone_number": "513-684-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANAMERONGEN",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "OH",
            "license": "35071348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2007; 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.