Jacalyn Ann Vandervort, RN

Primary specialty

Case Management Registered NurseTaxonomy code 163WC0400X

License

382602-1 Issued in NY

Practice address

99 Main St
Delhi, NY 13753-1221

Phone

(607) 832-5200

NPI assigned

Dec 8, 2010

Last updated

Dec 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1291766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1629371943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 MAIN ST",
            "city": "DELHI",
            "state": "NY",
            "postal_code": "137531221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 MAIN ST",
            "city": "DELHI",
            "state": "NY",
            "postal_code": "137531221",
            "telephone_number": "607-832-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVORT",
        "first_name": "JACALYN",
        "middle_name": "ANN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-08",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NY",
            "license": "382602-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Registered Nurse in Delhi, NY
• Providers in Delhi, NY by specialty
• Case Management Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.