Vickie L Vandeventer, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71003333A Issued in IN

Practice address

4935 W Arlington Rd
Bloomington, IN 47404-1187

Phone

(812) 353-3800

Fax

(812) 353-3770

NPI assigned

Sep 1, 2010

Sex

Female

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

Electronic endpoints 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: vvandeventer@direct.iuhealth.org

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.

• Indiana University Health Southern Indiana Physicians, LLC

  • Multi-Specialty Clinic/Center
  • Bloomington, IN
  • NPI 1013953983
  Medicare reassignment NPD
• Iu Health Medical Group, LLC

  • General Practice Physician
  • Indianapolis, IN
  • NPI 1326893777

  Family

  Medicare reassignment NPD
• Indiana University Health Southern Indiana Physicians LLC

  • Durable Medical Equipment & Medical Supplies
  • Bloomington, IN
  • NPI 1063179844
  NPD

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1770890568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1329",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474021329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4935 W ARLINGTON RD",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474041187",
            "telephone_number": "812-353-3800",
            "fax_number": "812-353-3770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1614 25th St",
            "address_purpose": "LOCATION",
            "city": "Bedford",
            "state": "IN",
            "postal_code": "474215000",
            "country_code": "US",
            "telephone_number": "812-270-0118",
            "fax_number": "812-277-0127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDEVENTER",
        "first_name": "VICKIE",
        "middle_name": "L",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-01",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003333A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201030630",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vvandeventer@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "4935 W Arlington Rd",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474041187",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vvandeventer@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1614 25th St",
            "city": "Bedford",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474215000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paul Joseph Vandekoppel, MD
• Madeleine Jane Vandenbrink, MD
• Larry Wayne Vandermolen, PA-C
• David Vandeventer, BCBA
• Jason R Vandeventer, MPT
• Grace Vandiver
• Sandra Ellen Vangilder
• Amara Vanmatre, RBT
• Veneda K Vann, N.P.
• Dean Vannasdale, O.D.

• Family Nurse Practitioner in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.