Individual provider Active NPI

Cynthia Diane Vandeusen, F.N.P. ; G.N.P.

  • Nurse Practitioner
  • Hendersonville, NC
National Provider Identifier
1558475244
Registry record updated Feb 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9501592 Issued in NC
Practice address
709 N Justice St
Suite B
Hendersonville, NC 28791-3454
Phone
(828) 696-1234
Fax
(828) 696-1257
NPI assigned
Aug 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9501592 NC Primary

Addresses

Primary practice location

709 N Justice St
Suite B
Hendersonville, NC 28791-3454

Mailing address

PO Box 63314
Charlotte, NC 28263-3314
Phone (828) 696-1312

Other identifiers 1

IdentifierTypeStateIssuer
7000776MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20100803000261 NC Practitioner - Nurse Practitioner 2163555715 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson County Hospital Corporation CurrentSince Nov 1, 1998 Accepting new patients
Henderson County Hospital Corporation Current Accepting new patients
Pardee Neurology Associates CurrentSince Nov 1, 1998 Accepting new patients

Locations

21 Turtle Creek Dr
Ste 100
Asheville, NC 28803
Phone (828) 435-8394

709 N Justice St
Ste B
Hendersonvlle, NC 28791
Phone (828) 696-1255

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360713600000",
    "number": "1558475244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63314",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633314",
            "telephone_number": "828-696-1312",
            "fax_number": "828-696-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 N JUSTICE ST",
            "address_2": "SUITE B",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287913454",
            "telephone_number": "828-696-1234",
            "fax_number": "828-696-1257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEUSEN",
        "first_name": "CYNTHIA",
        "middle_name": "DIANE",
        "credential": "F.N.P. ; G.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-18",
        "last_updated": "2013-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "9501592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000776",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

Verify at the official NPI Registry.