Kenneth Luckie Vandervoort, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MD.13298 Issued in AL

Practice address

731 Leighton Ave Ste 300
Anniston, AL 36207-5762

Phone

(256) 236-4121

Fax

(256) 237-5254

NPI assigned

Oct 20, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

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

Orthopedic Surgery

Education

University of Alabama School of Medicine, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Orthopaedic Alliance PLLCGroup PAC ID 2365800604, 102 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Home Health of Anniston Home health agency, Anniston, AL, CCN 017305
• Enhabit Home Health Home health agency, Hoover, AL, CCN 017009
• Northeast Alabama Regional Medical Center Hospital, Anniston, AL, CCN 010078

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• bcbs alabama network 01B0
• bcbs alabama network 01G0
• bcbs alabama network 01A0
• bcbs alabama network 01E0
• bcbs alabama network 01H0

Interoperability endpoints

• Direct secure messaging: klvandervoort@aoa.gwaydirect.com
• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1445

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.

• Southern Orthopaedic Alliance, PLLC

  • Orthopaedic Surgery Physician
  • Mobile, AL
  • NPI 1588364228
  Medicare reassignment Care Compare group NPD
• Anniston Orthopedics Associates PA

  • Physical Therapy Clinic/Center
  • Anniston, AL
  • NPI 1366636706
  Medicare reassignment NPD
• Anniston Orthopedics Associates PA

  • Orthopaedic Surgery Physician
  • Anniston, AL
  • NPI 1114916681
  NPD
• Southern Orthopaedic Alliance PLLC

  • Durable Medical Equipment & Medical Supplies
  • Brewton, AL
  • NPI 1093561896

  Orthopaedic Surgery

  NPD

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

• Amedisys Alabama, LLC

  • Home Health Agency
  • Anniston, AL
  • NPI 1245298892
  Care Compare affiliation
• Eh Health Home Health of Birmingham, LLC

  • Home Health Agency
  • Hoover, AL
  • NPI 1629539077
  Care Compare affiliation
• The Health Care Authority of the City of Anniston

  • General Acute Care Hospital
  • Anniston, AL
  • NPI 1003996000
  Care Compare affiliation

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1912996158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 LEIGHTON AVE STE 300",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362075762",
            "telephone_number": "256-236-4121",
            "fax_number": "256-237-5254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 LEIGHTON AVE STE 300",
            "city": "ANNISTON",
            "state": "AL",
            "postal_code": "362075762",
            "telephone_number": "256-236-4121",
            "fax_number": "256-237-5254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVOORT",
        "first_name": "KENNETH",
        "middle_name": "LUCKIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "00013298",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "AL",
            "license": "MD.13298",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000017436",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "051017436",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John F Valente, M.D.
• Maurice Daniele Valentini, O.D.
• Pablo Valle-Blacio, MD
• Andrea Van Akin, BCBA, LBA
• Joshua Wayne Vander Windt, PT
• Christine Vanek
• Pratibha Sonam Vashista, D.O.
• Stephen Mark Vaughn
• Edwin M Villaespn, PT
• Jessica Williams Vincent, M.D.

• Orthopaedic Surgery Physician in Anniston, AL
• Providers in Anniston, AL by specialty
• Orthopaedic Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; 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.