Pamela Vandermark, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

71003764A Issued in IN

Practice address

2451 Intelliplex Dr Ste 260
Shelbyville, IN 46176-8580

Phone

(317) 398-0121

Fax

(317) 398-0538

NPI assigned

Nov 21, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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 1

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Major HospitalGroup PAC ID 0446167415, 100 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Suburban Home Health LLC Home health agency, Noblesville, IN, CCN 157092
• Major Hospital Hospital, Shelbyville, IN, CCN 150097

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  Medicare reassignment Care Compare group NPD
• Major Hospital

  • Rural Health Clinic/Center
  • Shelbyville, IN
  • NPI 1689421554
  NPD
• X-Ray Physicians of Shelbyville PC

  • Diagnostic Radiology Physician
  • Shelbyville, IN
  • NPI 1144351347
  NPD
• Major Hospital

  • Skilled Nursing Facility
  • Gary, IN
  • NPI 1306953740
  NPD (past)

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

• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  Care Compare affiliation
• Suburban Home Health, LLC

  • Home Health Agency
  • Noblesville, IN
  • NPI 1598872939
  Care Compare affiliation

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

{
    "created_epoch": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599696000000",
    "number": "1740557610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W RAMPART ST STE 200",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768846",
            "telephone_number": "317-398-0121",
            "fax_number": "317-398-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 INTELLIPLEX DR STE 260",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461768580",
            "telephone_number": "317-398-0121",
            "fax_number": "317-398-0538"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3834 S Emerson Ave",
            "address_2": "Building C, Suite 100",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "46203",
            "country_code": "US",
            "telephone_number": "317-782-1577",
            "fax_number": "317-780-5538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERMARK",
        "first_name": "PAMELA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2020-09-10",
        "certification_date": "2020-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28154814A",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IN",
            "license": "71003764A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201042790",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• United RX LLC
• Kaelee Urban
• Urology of Indiana L.L.C.
• Usrc MHP, LLC
• Arise Uwizeyimana
• Megan Alexis Vanover, PHARMD
• Rylee McKinsey Vanover
• Alexander John Verbarg
• Vida Oncology LLC
• Carlos Vieira, MD

• Gerontology Nurse Practitioner in Shelbyville, IN
• Providers in Shelbyville, IN by specialty
• Gerontology Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.