Richard J Vandam, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

071296 Issued in GA

Practice address

1266 Highway 515
Piedmont Mountainside Hospital
Jasper, GA 30143

Phone

(404) 977-8043

NPI assigned

Apr 15, 2011

Last updated

May 5, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Richard Jacob Vandam Professional name

Medicare fee-for-service enrollment

Enrolled in KY

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

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.

• Apogee Medical Group Kentucky PSC

  • General Practice Physician
  • Corbin, KY
  • NPI 1356503114
  Medicare reassignment NPD

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

{
    "created_epoch": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430784000000",
    "number": "1851681415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1266 HIGHWAY 515",
            "address_2": "PIEDMONT MOUNTAINSIDE HOSPITAL",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "30143",
            "telephone_number": "404-977-8043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1266 HIGHWAY 515",
            "address_2": "PIEDMONT MOUNTAINSIDE HOSPITAL",
            "city": "JASPER",
            "state": "GA",
            "postal_code": "30143",
            "telephone_number": "404-977-8043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDAM",
        "first_name": "RICHARD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-15",
        "last_updated": "2015-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "071296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RICHARD",
            "last_name": "VANDAM",
            "middle_name": "JACOB",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• United Family Therapy, LLC
• United Rehab Inc (United Rehab of Jasper)
• Uplift Pelvic Health, LLC
• Ashley Valderrama, MS, CCC-SLP
• Van Tuyl Dental Group
• Victory Village
• Village Podiatry Group, LLC
• Village Podiatry Group, LLC
• Wal-Mart Stores East LP (Walmart Pharmacy 10-5786)
• Wal-Mart Stores East LP (Vision Center 30-5786)

• Internal Medicine Physician in Jasper, GA
• Providers in Jasper, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2015; 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.