Jessica M Vanderham, CNP | |
513 3rd St Sw, Wagner, SD 57380-9675 | |
(605) 384-3611 | |
Not Available |
Full Name | Jessica M Vanderham |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 7 Years |
Location | 513 3rd St Sw, Wagner, South Dakota |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285143891 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | CP001277 (South Dakota) | Secondary |
363LF0000X | Nurse Practitioner - Family | 5017905 (North Carolina) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Kernersville Emergency Group, Pllc | 3375885429 | 29 |
Tanglewood Park Physicians Pllc | 3476895129 | 23 |
Lake Norman Emergency Medical Associates Llc | 5496927972 | 10 |
Piedmont Triad Physicians Pllc | 6406197334 | 20 |
Entity Name | Lake Norman Emergency Medical Associates Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053690560 PECOS PAC ID: 5496927972 Enrollment ID: O20111005000200 |
Entity Name | Lake Norman Inpatient Specialists |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851766885 PECOS PAC ID: 7315241338 Enrollment ID: O20160210002905 |
Entity Name | Piedmont Triad Physicians Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1295206464 PECOS PAC ID: 6406197334 Enrollment ID: O20190403000344 |
Entity Name | Kernersville Emergency Group, Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1750852034 PECOS PAC ID: 3375885429 Enrollment ID: O20190422001205 |
Entity Name | Tanglewood Park Physicians Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1093286379 PECOS PAC ID: 3476895129 Enrollment ID: O20190429001041 |
Mailing Address | Practice Location Address |
---|---|
Jessica M Vanderham, CNP 6915 Village Medical Cir, Clemmons, NC 27012-8002 Ph: (336) 893-1000 | Jessica M Vanderham, CNP 513 3rd St Sw, Wagner, SD 57380-9675 Ph: (605) 384-3611 |
Lindsey Nedved, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611 | |
Carol Lee Stewart, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 513 3rd Street Sw, Wagner, SD 57380 Phone: 605-384-3611 | |
Ashley Marie Ruhaak, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611 | |
Jazmyn Soukup, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611 | |
Brooke Lynn Plooster, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611 Fax: 605-384-5240 | |
Ryan Kocer, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 513 3rd St Sw, Wagner, SD 57380 Phone: 605-384-3611 |