Victoria Rae Rundus, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD36930 Issued in TN

Practice address

648 Hartsville Pike
Gallatin, TN 37066

Phone

(615) 451-9246

Fax

(615) 575-5040

NPI assigned

Dec 19, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in TN

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

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Vip Midsouth, LLC

  • Rural Health Clinic/Center
  • Pleasant View, TN
  • NPI 1336722669

  Corporate Director

  CMS ownership
• Vip Midsouth, LLC

  • Rural Health Clinic/Center
  • Springfield, TN
  • NPI 1528641859

  Corporate Director

  CMS ownership
• Vip Midsouth, LLC

  • Rural Health Clinic/Center
  • Lafayette, TN
  • NPI 1588247811

  Corporate Director

  CMS ownership

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.

• Vip Midsouth, LLC

  • Pediatrics Physician
  • Gallatin, TN
  • NPI 1487737912

  Pediatrics, TN

  Medicare reassignment NPD
• Vip Midsouth, LLC

  • Rural Health Clinic/Center
  • Pleasant View, TN
  • NPI 1336722669
  NPD
• Vip Midsouth, LLC

  • Rural Health Clinic/Center
  • Lafayette, TN
  • NPI 1588247811
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1821151804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "648 HARTSVILLE PIKE",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "37066",
            "telephone_number": "615-451-9246",
            "fax_number": "615-575-5040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "648 HARTSVILLE PIKE",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "37066",
            "telephone_number": "615-451-9246",
            "fax_number": "615-575-5040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUNDUS",
        "first_name": "VICTORIA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2023-03-07",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "MD36930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1510381",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "victoria.rundus@vipms.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "648 Hartsville Pike",
            "city": "Gallatin",
            "state": "TN",
            "country_code": "US",
            "postal_code": "37066",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara M Root, LMFT
• Stephen Matthew Rose, M.D.
• Jordan Chase Rosemore, OTR/L
• Meredith Rothschild
• Charles S Ruark Jr., MD
• Emily Runyan, LMFT
• Austin Runyon, DDS
• Rodney Dean Runyon, DDS
• Staci Elizabeth Rush, RN
• Bradley S Rust, MD

• All providers in Gallatin, TN
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.