Individual provider Active NPI

Chad Vanhill, CCP

  • Perfusionist
  • Burlingame, CA
National Provider Identifier
1730847005
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PerfusionistTaxonomy code 242T00000X
License
089077
Practice address
1501 Trousdale Dr
Burlingame, CA 94010-4506
Phone
(650) 799-8991
NPI assigned
Dec 3, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Perfusionist 242T00000X 089077 Primary

Addresses

Primary practice location

1501 Trousdale Dr
Burlingame, CA 94010-4506

Mailing address

2079 E Woodstone Dr
Hayden, ID 83835-8625
Phone (208) 651-6995

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

NPI Registry JSON

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1730847005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2079 E WOODSTONE DR",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838358625",
            "telephone_number": "208-651-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 TROUSDALE DR",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940104506",
            "telephone_number": "650-799-8991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANHILL",
        "first_name": "CHAD",
        "credential": "CCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": null,
            "license": "089077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlingame, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.