Roy Douglas Vanderpool, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

C7986 Issued in AR

Practice address

2552 E. Joyce Blvd.
Suite B
Fayetteville, AR 72703-4553

Phone

(479) 571-8585

Fax

(479) 571-4005

NPI assigned

Dec 22, 2008

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Cooper Clinic PA

  • Multi-Specialty Clinic/Center
  • Fort Smith, AR
  • NPI 1154341931
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1229904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1962648980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2552 E. JOYCE BLVD.",
            "address_2": "SUITE B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034553",
            "telephone_number": "479-571-8585",
            "fax_number": "479-571-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2552 E. JOYCE BLVD.",
            "address_2": "SUITE B",
            "city": "FAYETTEVILLE",
            "state": "AR",
            "postal_code": "727034553",
            "telephone_number": "479-571-8585",
            "fax_number": "479-571-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERPOOL",
        "first_name": "ROY",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-22",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AR",
            "license": "C7986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Jane Valentine Van Horn I
• Donna M Van Kirk, EDD
• Kelsey Erin Van Slyke, CRNA
• Waylon Vande Hoef
• John R Vanderbush, O.D.
• Kelvin Vann
• Terry Gene Vansandt, MHPP
• Carol Esther Vanscyoc, O.D.
• Vantage Point of Nwa
• Iyamilet Vargas Alvarez, DDS

• Plastic Surgery Physician in Fayetteville, AR
• Providers in Fayetteville, AR by specialty
• Plastic Surgery Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.