Anne Theresa Vaillancourt, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

100680 Issued in NC

Practice address

1728 Fordham Blvd
151 Ram'S Plaza
Chapel Hill, NC 27514-2397

Phone

(919) 968-1985

Fax

(919) 942-0038

NPI assigned

Dec 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458777600000",
    "number": "1982763306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63362",
            "address_2": "151 RAM'S PLAZA",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633362",
            "telephone_number": "919-620-4918",
            "fax_number": "919-620-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1728 FORDHAM BLVD",
            "address_2": "151 RAM'S PLAZA",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275142397",
            "telephone_number": "919-968-1985",
            "fax_number": "919-942-0038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAILLANCOURT",
        "first_name": "ANNE",
        "middle_name": "THERESA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-08",
        "last_updated": "2016-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "100680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "100680",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy M Ursano, MD
• Barbara M Usher, RN
• Dilek Uyan
• Daniel Nosike Uzochukwu
• Sara Vaca Anaya
• Robert Arthur Vaillancourt, LCSW
• Sandeep Vaishnavi, M.D.
• Jonathan Tan Valbuena, PT
• Celeslie Valcourt-Hall, LCSW
• Nataly Adriana Valdibia

• Physician Assistant in Chapel Hill, NC
• Providers in Chapel Hill, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2016; 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.