Lauren Nichole Vanderburg

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN0000022895 Issued in TN

Practice address

3451 Goodman Rd E Ste 115
Southaven, MS 38672-9304

Phone

(662) 890-5555

Fax

(662) 890-8899

NPI assigned

Apr 28, 2017

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

Enrolled in TN, MS2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Family Medical Clinic of North Ms IncGroup PAC ID 5294790861, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141
• Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: laurenvanderburg@fmconm-ms.direct.office.nextgen.com

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.

• Family Medical Clinic of North Ms Inc

  • Family Medicine Physician
  • Southaven, MS
  • NPI 1134174154
  Medicare reassignment Care Compare group
• Southeastern Emergency Services P C

  • Nurse Practitioner
  • Athens, TN
  • NPI 1669414264
  Medicare reassignment

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

• Baptist Memorial Hospital-Desoto, Inc,

  • General Acute Care Hospital
  • Southaven, MS
  • NPI 1194789818
  Care Compare affiliation
• Baptist Memorial Hospital

  • General Acute Care Hospital
  • Memphis, TN
  • NPI 1578527172
  Care Compare affiliation

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

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1669907424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 GOODMAN E RD 115",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729304",
            "telephone_number": "662-890-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 GOODMAN RD E STE 115",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729304",
            "telephone_number": "662-890-5555",
            "fax_number": "662-890-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBURG",
        "first_name": "LAUREN",
        "middle_name": "NICHOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-28",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000022895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taji J Valentine
• Nikii Vales, LPN
• Vivian Celeste Valladares, MD
• Sai Krishna Vallamchetla
• Quy Cong Van
• Michael Henry Vaughan, M.D.
• Kelly Lynn Velasquez, PMHNP
• Deborah Verucchi, CNP
• Samantha Shorter Vickrey, FNP
• Alissa M Villarrubia, MS, RD, LD

• Nurse Practitioner in Southaven, MS
• Providers in Southaven, MS by specialty
• Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.