Individual provider Active NPI

Bevan Londergan, M.D.

  • Pediatric Anesthesiology Physician
  • Nashville, TN
National Provider Identifier
1730382276
Registry record updated Mar 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
MD57600 Issued in TN
Practice address
3601 The Vanderbilt Clinic
Nashville, TN 37232
Phone
(615) 322-3000
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 050268 CT
Pediatric Anesthesiology Physician 207LP3000X 15668 FL
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Anesthesiology Physician 207LP3000X MD57600 TN Primary

Addresses

Primary practice location

3601 The Vanderbilt Clinic
Nashville, TN 37232

Mailing address

3841 Green Hills Village Dr Ste 200
Nashville, TN 37215-2691
Phone (615) 936-2000

Other practice location 1

807 Childrens Way
Dept of Anesthesia
Jacksonville, FL 32207-8426
Phone (904) 202-8275

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address blondergan415706@direct.vumc.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, TN2 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

Enrollment IDStateProvider typePAC IDDetails
I20120723000753 FL Practitioner - Anesthesiology 5698931467 Reassigns benefits to 1 organization
I20180823003668 TN Practitioner - AnesthesiologyPractitioner - Pediatric Medicine 5698931467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
AnesthesiologyAlso: Pediatric Medicine
Education
University of Connecticut School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vanderbilt University Medical CenterGroup PAC ID 5092023416, 3,510 clinicians

Practice addresses (Care Compare)

1301 22ND Ave S
Nashville, TN 37232-5100
Phone (615) 322-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
050268CTMDAnesthesiology Physician
MD57600TNMDPediatric Anesthesiology Physician
15668FLMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vanderbilt University Medical Center Anesthesiology CurrentSince Aug 6, 2018 Accepting new patients
The Nemours Foundation CurrentSince Jul 16, 2012 Accepting new patients
The Nemours Foundation CurrentSince Jul 16, 2012 Accepting new patients
The Nemours Foundation Current Accepting new patients

Locations

807 Childrens Way
Jacksonville, FL 32207
Phone (904) 390-3600

Dept A T 40379
Atlanta, GA 31192

3841 Green Hills Village Dr
Ste 200
Nashville, TN 37215
Phone (615) 322-6842

719 Thompson Ln
Nashville, TN 37204
Phone (615) 322-6485

719 Thompson Ln
Ste 30330
Nashville, TN 37204
Phone (615) 936-3871

Interoperability endpoints

  • Direct secure messaging: blondergan415706@direct.vumc.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647561600000",
    "number": "1730382276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3841 GREEN HILLS VILLAGE DR STE 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372152691",
            "telephone_number": "615-936-2000",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 THE VANDERBILT CLINIC",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37232",
            "telephone_number": "615-322-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "807 Childrens Way",
            "address_2": "Dept of Anesthesia",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078426",
            "country_code": "US",
            "telephone_number": "904-202-8275",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONDERGAN",
        "first_name": "BEVAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2022-03-18",
        "certification_date": "2022-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CT",
            "license": "050268",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "FL",
            "license": "15668",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "TN",
            "license": "MD57600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "blondergan415706@direct.vumc.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Health Information Service Provider",
            "address_1": "3601 The Vanderbilt Clinic",
            "city": "Nashville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.