Individual provider Active NPI

Harold Mark Vandersea, M.D.

  • Orthopaedic Surgery Physician
  • New Bern, NC
National Provider Identifier
1750376570
Registry record updated Oct 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
21520 Issued in NC
Practice address
738 Newman Rd
New Bern, NC 28562-5238
Phone
(252) 634-2676
Fax
(252) 633-3502
NPI assigned
Sep 19, 2005
Last updated
Oct 19, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 21520 NC Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 21520 NC

Addresses

Primary practice location

738 Newman Rd
New Bern, NC 28562-5238

Mailing address

738 Newman Rd
New Bern, NC 28562-5238
Phone (252) 634-2676

Other identifiers 2

IdentifierTypeStateIssuer
8984670MedicaidNC
84670OtherNCBCBS

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21520NCMDSports Medicine (Orthopaedic Surgery) Physician

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350604800000",
    "number": "1750376570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625238",
            "telephone_number": "252-634-2676",
            "fax_number": "252-633-3502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 NEWMAN RD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285625238",
            "telephone_number": "252-634-2676",
            "fax_number": "252-633-3502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERSEA",
        "first_name": "HAROLD",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2012-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "21520",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "NC",
            "license": "21520",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8984670",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "84670",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2012; 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.