Roger Vandyk, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

10591 Issued in TN

Practice address

501 20TH St
Suite 606
Knoxville, TN 37916-1809

Phone

(865) 546-8040

Fax

(846) 541-2787

NPI assigned

Jun 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

Practice roles

Locations

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.

• American Anesthesiology of Tennessee, P.C.

  • Anesthesiology Physician
  • Knoxville, TN
  • NPI 1609822998
  Medicare reassignment NPD
• Covenant Anesthesia Group, PC

  • Anesthesiology Physician
  • Oak Ridge, TN
  • NPI 1639148117
  Medicare reassignment NPD
• American Anesthesiology of Tennessee, P.C.

  • Certified Registered Nurse Anesthetist
  • Knoxville, TN
  • NPI 1245279777

  Nurse Anesthetist, Certified Registered

  NPD

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277683200000",
    "number": "1629019575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 20TH ST",
            "address_2": "SUITE 606",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161809",
            "telephone_number": "865-546-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 20TH ST",
            "address_2": "SUITE 606",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379161809",
            "telephone_number": "865-546-8040",
            "fax_number": "846-541-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYK",
        "first_name": "ROGER",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2010-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "10591",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3037710",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHP TENNCARE",
            "identifier": "100021702",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3602923",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE TRAVELERS",
            "identifier": "430009525",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECARE",
            "identifier": "3037710",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William L Vandergriff, M.D.
• Jennifer Vanderveer
• Adriana Lynn Vanderwerf, APRN, FNP-C
• Cheryl L Vandewege
• Traci Vandiver, BA
• Alex Brian Vanlandingham, DO
• Cydney Vanosdale, FNP-BC
• Stephanie G Vanterpool, M.D.
• Carma Vantrease
• Lucille R Vara, APN-BC

• Certified Registered Nurse Anesthetist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.