Joel Leonard Vanderford

Primary specialty

Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X

License

54641 Issued in AZ

Practice address

2100 Stantonsburg Rd
PCMH Graduate Medical Education
Greenville, NC 27834-2818

Phone

(252) 847-4268

NPI assigned

Jun 14, 2007

Last updated

Sep 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GU

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Guam Healthcare Development Incorporated

  dba GRMC Specialty Care Center

  • Clinic/Center
  • Dededo, GU
  • NPI 1326447939
  Medicare reassignment NPD

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1770787400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "address_2": "PCMH GRADUATE MEDICAL EDUCATION",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-847-4268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "address_2": "PCMH GRADUATE MEDICAL EDUCATION",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-847-4268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERFORD",
        "first_name": "JOEL",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "AZ",
            "license": "54641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300867",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rustan Joel Van Wyk, D.O.
• Chelsea Lynn Vanaken, DO
• Laila Vance
• Andrew James Vande Berg, ATC
• Kristin Maddox Vandenbussche, LCSW-A
• Andrew Schuil Vanderveer, M.D.
• Victoria Vang
• Richard Vantienderen, DO
• Maryann L Vanvoorhees, CRNA
• Marisol Vargas, FNP-C

• Pediatric Critical Care Medicine Physician in Greenville, NC
• Providers in Greenville, NC by specialty
• Pediatric Critical Care Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.