Individual provider Active NPI

James Michael Vandermark, FNP-C

  • Family Nurse Practitioner
  • Schererville, IN
National Provider Identifier
1609534791
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71012159A Issued in IN
Practice address
1500 US Highway 41
Schererville, IN 46375-1316
Phone
(219) 440-7373
NPI assigned
Dec 6, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71012159A IN Primary
Registered Nurse 163W00000X 28244587A IN

Addresses

Primary practice location

1500 US Highway 41
Schererville, IN 46375-1316

Mailing address

1500 US Highway 41
Schererville, IN 46375-1316
Phone (219) 440-7373

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20230824003786 IN Practitioner - Nurse Practitioner 0547646416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois Center for Pain Control LLCGroup PAC ID 4688999550, 5 clinicians

Practice addresses (Care Compare)

10176 W 400 N B
The Vanguard Medical Group
Michigan City, IN 46360-9009
Phone (219) 301-2633

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71012159AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois Center for Pain Control LLC CurrentSince Aug 1, 2023 Accepting new patients
Axess Clinic and Diagnostics LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

300 W 80th Pl
Ste D
Merrillville, IN 46410
Phone (219) 769-6037

10176 W 400 N
Ste A
Michigan City, IN 46360
Phone (219) 809-9839

10176 W 400 N
Ste B
Michigan City, IN 46360
Phone (219) 301-2633

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 and National Provider Directory roles.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1638748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1609534791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 US HIGHWAY 41",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751316",
            "telephone_number": "219-440-7373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 US HIGHWAY 41",
            "city": "SCHERERVILLE",
            "state": "IN",
            "postal_code": "463751316",
            "telephone_number": "219-440-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMARK",
        "first_name": "JAMES",
        "middle_name": "MICHAEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-06",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71012159A",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28244587A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schererville, IN

Sources for this page

Verify at the official NPI Registry.