Individual provider Active NPI

Jillian Amanda Vandamme, APRN, FNP-C

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1528889367
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1178742 Issued in TX
Practice address
8110 W Loop 1604 N
San Antonio, TX 78254-2104
Phone
(210) 941-2282
NPI assigned
Oct 23, 2024
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 1178742 TX Primary

Addresses

Primary practice location

8110 W Loop 1604 N
San Antonio, TX 78254-2104

Mailing address

8423 Rocky Path St
San Antonio, TX 78254-2618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20250123002035 TX Practitioner - Nurse Practitioner 8224567029 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alamo City Urgent Care, LLCGroup PAC ID 8123370871, 12 clinicians

Practice addresses (Care Compare)

8110 W Loop 1604
Suite 102
San Antonio, TX 78254-6824
Phone (210) 951-4321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1178742TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Alamo City Urgent Care, LLC Single Specialty CurrentSince Dec 16, 2024 Accepting new patients

Locations

8110 W Loop 1604 N
San Antonio, TX 78254
Phone (210) 941-2282

8110 W Loop 1604 N
Ste 102
San Antonio, TX 78254
Phone (210) 951-4321

8223 Marbach Rd
Ste 102
San Antonio, TX 78227
Phone (210) 762-5141

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1729641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1528889367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8423 ROCKY PATH ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782542618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 W LOOP 1604 N",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782542104",
            "telephone_number": "210-941-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDAMME",
        "first_name": "JILLIAN",
        "middle_name": "AMANDA",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-23",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1178742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.