Active NPI
Nathan Paul Vandervinne, DO
- Emergency Medicine Physician
- Orangeburg, SC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 83102
- Practice address
- 3000 Saint Matthews Rd
Orangeburg, SC 29118-1442 - Phone
- (803) 395-2000
- NPI assigned
- May 26, 2017
- Last updated
- Mar 15, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 02005448A | IN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 11019228A | IN | |
| Emergency Medicine Physician | 207P00000X | 83102 | SC | Primary |
Addresses
Primary practice location
3000 Saint Matthews Rd
Orangeburg, SC 29118-1442
Mailing address
25 Old Summer House Rd
Charleston, SC 29412-3227
Phone (815) 618-8424
Other practice location 1
1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (317) 962-5975
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83102 | SC | MD | Sports Medicine (Preventive Medicine) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sound Physicians Emergency Medicine of South Carolina LLC | Emergency Medicine | Current | Accepting new patients |
| University Medical Diagnostic Associates, Inc. | Past | Accepting new patients |
Locations
302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940
3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200
Interoperability endpoints
- nvandervinne446187@direct.musc.edu
Organizations & group practices 2
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.
-
- Emergency Medicine Physician
- Aiken, SC
- NPI 1730636168
-
- Internal Medicine Physician
- Indianapolis, IN
- NPI 1861441537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615766400000",
"number": "1902334568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 OLD SUMMER HOUSE RD",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294123227",
"telephone_number": "815-618-8424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3000 SAINT MATTHEWS RD",
"city": "ORANGEBURG",
"state": "SC",
"postal_code": "291181442",
"telephone_number": "803-395-2000"
}
],
"practiceLocations": [
{
"address_1": "1701 N Senate Blvd",
"address_purpose": "LOCATION",
"city": "Indianapolis",
"state": "IN",
"postal_code": "462021239",
"country_code": "US",
"telephone_number": "317-962-5975",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDERVINNE",
"first_name": "NATHAN",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-26",
"last_updated": "2021-03-15",
"certification_date": "2021-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "IN",
"license": "02005448A",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IN",
"license": "11019228A",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "83102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orangeburg, SC
- United Dental Group, LLC
- United Rehab Inc (United Rehab of Orangeburg)
- Kevin Scott Uren, DPM
- Sabrina Valentine, PHARMD
- Valtic
- Robert A. Varn, DMD
- William Varn
- Veil Home Health and Hospice LLC (The Veil Home Care Service)
- Veil Home Health and Hospice, LLC (Veil Home Health and Hospice DME)
- Vein Center MD, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.