Jed B Vandenberghe, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

871778461205 Issued in UT

Practice address

2180 E 4500 S
Salt Lake City, UT 84117-4434

Phone

(801) 278-4693

NPI assigned

Aug 14, 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

Medicare fee-for-service enrollment

Enrolled in UT

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

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 and National Provider Directory roles.

• Jed Vandenberghe MD PC

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1841171790
  Medicare reassignment NPD Authorized official
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment NPD
• Ihc Health Services Inc

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • American Fork, UT
  • NPI 1437576212
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1922011576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-278-4693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 E 4500 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174434",
            "telephone_number": "801-278-4693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERGHE",
        "first_name": "JED",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "871778461205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Devin Vance, MFP
• Larry Robert Vance, D.C.
• Tyra Mae Vance
• Elise-Marie Sabine Vandamme
• Matthew Vandenberg, CPHT
• Isabel Vander Hyde, OTR/L
• Judith Ann Vander Ziel, L.C.S.W.
• Haley Michelle Vanderhill
• Daniel P. Vanderhoef, MD
• J Eric Vanderhooft, MD

• Pediatrics Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Pediatrics Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.