Samuel B Vanlandingham, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

01036354 Issued in IN

Practice address

1919 Lake Ave
Suite 102
Plymouth, IN 46563-7830

Phone

(574) 941-2967

Fax

(574) 941-2968

NPI assigned

May 23, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Saint Joseph Regional Medical Center, Inc.

  • Pulmonary Disease Physician
  • Plymouth, IN
  • NPI 1225082878
  NPD (past)
• Saint Joseph Regional Medical Center, Inc.

  • Family Medicine Physician
  • Mishawaka, IN
  • NPI 1467406074
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235433600000",
    "number": "1871548438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6309",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466606309",
            "telephone_number": "574-472-6700",
            "fax_number": "574-472-6746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 LAKE AVE",
            "address_2": "SUITE 102",
            "city": "PLYMOUTH",
            "state": "IN",
            "postal_code": "465637830",
            "telephone_number": "574-941-2967",
            "fax_number": "574-941-2968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANLANDINGHAM",
        "first_name": "SAMUEL",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2009-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IN",
            "license": "01036354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000346996",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251960",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Trusty, RBT
• Jillorna Ann Uceny, MSW, ACSW, LCSW, BCD
• Zubair Ul Haq, M.B.B.S., M.D.
• Jacqueline Carole Vander Velden
• Zachary Rene Vandevoorde, DMD
• Dulce Vargas
• Katrina Jean Vargas, NP
• Sarina Vice
• Tiffany Vogeler, PHARMD
• Robert O Vore, OD

• Surgery Physician in Plymouth, IN
• Providers in Plymouth, IN by specialty
• Surgery Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.

Verify at the official NPI Registry.