Xiomara Antonetti Vance, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2020-00137 Issued in NC

Practice address

317 Western Blvd
Jacksonville, NC 28546-6338

Phone

(910) 577-2345

NPI assigned

Mar 24, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Xiomara Antonetti Former name

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Emergency Medicine

Education

New York Medical College, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Delaware River Medicine PLLCGroup PAC ID 4981034550, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bon Secours Community Hospital Hospital, Port Jervis, NY, CCN 330135
• St Anthony Community Hospital Hospital, Warwick, NY, CCN 330205

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Delaware River Medicine, PLLC

  • Emergency Medicine Physician
  • Port Jervis, NY
  • NPI 1457987521
  Medicare reassignment Care Compare group NPD
• North Shore-Lij Medical PC

  dba NHPP Cardiology at Great Neck

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Emergency Medicine

  Medicare reassignment NPD
• Emergency Coverage, LLC

  dba Emergency Coverage Corporation of TeamHealth

  • Family Medicine Physician
  • Newport, TN
  • NPI 1427005008

  Emergency Medicine

  NPD
• Emergency Coverage Services, PC

  • Nurse Practitioner
  • Lawrenceburg, TN
  • NPI 1053351593
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bon Secours Community Hospital

  • General Acute Care Hospital
  • Port Jervis, NY
  • NPI 1659360709
  Care Compare affiliation
• St. Anthony Community Hospital

  • General Acute Care Hospital
  • Warwick, NY
  • NPI 1598755324
  Care Compare affiliation

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

{
    "created_epoch": "1427155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580860800000",
    "number": "1902290281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "317 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466338",
            "telephone_number": "910-577-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 WESTERN BLVD",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285466338",
            "telephone_number": "910-577-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "XIOMARA",
        "middle_name": "ANTONETTI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-24",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "293040-1",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2020-00137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "XIOMARA",
            "last_name": "ANTONETTI",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaylyn Vaillancourt, PT, DPT
• Ivelisse M Valentin, MA, BCBA, LBA
• Karen Esbeidy Valentine, MSW
• Melissa Vallario
• Paula Valles, LCSWA
• Brianna Lee Vanderpool, PMHNP-BC
• Charity J.E. Vanderwall-Lacey, DMD
• Tess Marie Vanderwerf, DPT
• Richard John Vanek Sr., DDS MSCO
• Jenna Jovet Vannoy

• Emergency Medicine Physician in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Emergency Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.