Individual provider Active NPI

Brice David Vanderpool, MD

  • Surgery Physician
  • Dallas, TX
National Provider Identifier
1598735979
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C5909 Issued in TX
Practice address
3808 Swiss Ave
Dallas, TX 75204-6449
Phone
(214) 823-2650
Fax
(214) 824-2404
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C5909 TX Primary

Addresses

Primary practice location

3808 Swiss Ave
Dallas, TX 75204-6449

Mailing address

3808 Swiss Ave
Dallas, TX 75204-6449
Phone (214) 823-2650

Other identifiers 1

IdentifierTypeStateIssuer
88G481OtherTXBC/BS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091118000029 TX Practitioner - General Surgery 0941348619 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Aj Applewhite MD PA CurrentSince Jun 1, 2016 Accepting new patients
Westmoreland & Arnold MD PLLC Surgery CurrentSince Sep 14, 1989 Accepting new patients
Colleen I. Kennedy, MD, PA Surgery Past Accepting new patients

Locations

3500 Gaston Ave
Ste 210
Dallas, TX 75246
Phone (214) 820-4400

3808 Swiss Ave
Dallas, TX 75204
Phone (214) 775-1356

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/defbea08-f7c0-41b2-bfd7-5c64c68d3dd5/

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": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200614400000",
    "number": "1598735979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 SWISS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046449",
            "telephone_number": "214-823-2650",
            "fax_number": "214-824-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 SWISS AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046449",
            "telephone_number": "214-823-2650",
            "fax_number": "214-824-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERPOOL",
        "first_name": "BRICE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2008-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "C5909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "88G481",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.