Robert R Vandermyde

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1085 Maple St
Farmington, MO 63640-1955

Phone

(573) 482-5334

NPI assigned

Sep 25, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

BJC Behavioral HealthGroup PAC ID 1153225271, shared by 2 NPIs, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• BJC Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Louis, MO
  • NPI 1669485868
  Medicare reassignment NPD
• BJC Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Farmington, MO
  • NPI 1801807847
  Medicare reassignment NPD

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

{
    "created_epoch": "1632528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1689345951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N WASHINGTON ST STE 229",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401716",
            "telephone_number": "573-218-9699",
            "fax_number": "573-803-1405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 MAPLE ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401955",
            "telephone_number": "573-482-5334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Washington St Ste 229",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "MO",
            "postal_code": "636401716",
            "country_code": "US",
            "telephone_number": "573-218-9699",
            "fax_number": "573-803-1405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERMYDE",
        "first_name": "ROBERT",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-25",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madelyn Usherwood, MA, PLPC
• Amin A Valliani, MD
• Valor Wellness Missouri LLC
• Van Ness Orthopedics & Sports Medicine Inc
• Caitlin Vance, B.S
• Sekhar Vangala, M.D.
• Scott Allen Vanness, D.O.
• Vicky L Winick
• Amy B Vinson, PLPC
• Jessica Lynn Vinyard, PTA

• Professional Counselor in Farmington, MO
• Providers in Farmington, MO by specialty
• Professional Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2024; 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.