Jeffrey Todd Van Dermark, MD

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

M2848 Issued in TX

Practice address

5323 Harry Hines Blvd
Dallas, TX 75390-7208

Phone

(214) 648-3067

NPI assigned

Apr 26, 2006

Last updated

Apr 22, 2008By the provider in NPPES

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 1

Medicare fee-for-service enrollment

Enrolled in TX, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1760452767
  NPD
• Fayette Community Hospital, Inc.

  dba Piedmont Fayette Hospital

  • General Acute Care Hospital
  • Fayetteville, GA
  • NPI 1528027240
  NPD (past)
• Peachtree Emergency Associates

  • Emergency Medicine Physician
  • Atlanta, GA
  • NPI 1407894876
  NPD (past)
• Piedmont Hospital, Inc

  dba Piedmont Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1962461681
  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208822400000",
    "number": "1639136617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347",
            "telephone_number": "214-648-3067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-648-3067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DERMARK",
        "first_name": "JEFFREY",
        "middle_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2008-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "TX",
            "license": "M2848",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176495301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abbey Kathryn Valvano, PHD
• Van a Johnson Jr MD PLLC
• April Elizabeth Van Anglen, MSN
• Troy Curtis Van Biezen, D.C.
• Lyndsey Kari Van Der Laan, M.D.
• Thomas G Van Dinter Jr., M.D.
• Barbara Van Drie, LPC-S
• Luana Maria Van Dunem Bartolomeu de Faria
• Richard Perry Van Dyke III, PHARMD.
• Michael Van Hal, M.D.

• Emergency Medical Services (Emergency Medicine) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.