NPIMap

Individual provider Active NPI

Austin Scott Vandusen, D.D.S.

  • Dentist
  • Clarksville, TN
National Provider Identifier
1639466022
Registry record updated Apr 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9292 Issued in TN
Practice address
800 Weatherly Dr
103-B
Clarksville, TN 37043-8957
Phone
(931) 647-8437
Fax
(931) 647-8439
NPI assigned
Jul 6, 2011
Last updated
Apr 20, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9292 TN Primary

Addresses

Primary practice location

800 Weatherly Dr
103-B
Clarksville, TN 37043-8957

Mailing address

800 Weatherly Dr
103-B
Clarksville, TN 37043-8957
Phone (931) 647-8437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Clarksville Dental Spa, PLLC Dentist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1309910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397952000000",
    "number": "1639466022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WEATHERLY DR",
            "address_2": "103-B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438957",
            "telephone_number": "931-647-8437",
            "fax_number": "931-647-8439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WEATHERLY DR",
            "address_2": "103-B",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370438957",
            "telephone_number": "931-647-8437",
            "fax_number": "931-647-8439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDUSEN",
        "first_name": "AUSTIN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-06",
        "last_updated": "2014-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "9292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2014; 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.