Individual provider Active NPI

Anna Vanderheiden, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Odessa, TX
National Provider Identifier
1740414630
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
P9020 Issued in TX
Practice address
701 W 5TH St
Odessa, TX 79763-4206
Phone
(432) 335-5250
NPI assigned
May 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BP10034890 TX
Endocrinology, Diabetes & Metabolism Physician 207RE0101X P9020 TX Primary

Addresses

Primary practice location

701 W 5TH St
Odessa, TX 79763-4206

Mailing address

405 Londonderry Dr 312
Waco, TX 76712-7922
Phone (254) 537-6530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20141117000271 TX Practitioner - Endocrinology 0446472054 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

6901 Medical Pkwy
Waco, TX 76712-7910
Phone (254) 751-4000

Hospital & facility affiliations

  • Ascension Providence Hospital, Waco, TX, CCN 450042
  • Hamilton General Hospital Hospital, Hamilton, TX, CCN 451392
  • Coryell Memorial Hospital Hospital, Gatesville, TX, CCN 451379
  • Goodall Witcher Hospital Hospital, Clifton, TX, CCN 451385
  • Parkview Regional Hospital Hospital, Mexia, TX, CCN 450400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BP10034890TXMDInternal Medicine Physician
P9020TXMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
Providence Health Alliance CurrentSince Sep 1, 2015 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Internal Medicine CurrentSince Nov 1, 2014 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Nov 1, 2014 Accepting new patients
Providence Health Alliance CurrentSince Sep 1, 2015 Accepting new patients

Locations

2201 Inwood Rd
Dallas, TX 75235
Phone (214) 645-2563

405 Londonderry Dr
Ste 312
Waco, TX 76712
Phone (254) 751-4300

405 Londonderry Dr
Ste 310
Waco, TX 76712
Phone (254) 399-6000

6901 Medical Pkwy
Waco, TX 76712
Phone (254) 751-4000

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

Interoperability endpoints

  • Direct secure messaging: anna.vanderheiden.1@9635.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1740414630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR 312",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127922",
            "telephone_number": "254-537-6530",
            "fax_number": "254-537-6531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 W 5TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797634206",
            "telephone_number": "432-335-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHEIDEN",
        "first_name": "ANNA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10034890",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "P9020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.