Active NPI
Mega Clare Vandenbergh Purino, PA-C
- Physician Assistant
- Hendersonville, TN
National Provider Identifier
1811138316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 748
- Practice address
- 353 New Shackle Island Rd
Suite 141-C
Hendersonville, TN 37075-2379 - Phone
- (615) 826-3142
- Fax
- (615) 447-1060
- NPI assigned
- Mar 12, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 748 | TN | Primary |
Addresses
Primary practice location
353 New Shackle Island Rd
Suite 141-C
Hendersonville, TN 37075-2379
Mailing address
353 New Shackle Island Rd
Suite 141-C
Hendersonville, TN 37075-2379
Phone (615) 826-3142
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 748 | TN | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236816000000",
"number": "1811138316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "353 NEW SHACKLE ISLAND RD",
"address_2": "SUITE 141-C",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370752379",
"telephone_number": "615-826-3142",
"fax_number": "615-447-1060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "353 NEW SHACKLE ISLAND RD",
"address_2": "SUITE 141-C",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370752379",
"telephone_number": "615-826-3142",
"fax_number": "615-447-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDENBERGH PURINO",
"first_name": "MEGA",
"middle_name": "CLARE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-12",
"last_updated": "2009-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.