JOHN M VANDEREN III (NPI# 1811986094) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811986094 |
| Entity Type | Individual |
| Full Name | JOHN M VANDEREN III |
| Credential | MD |
| Practice Address |
613 23rd St Ste 230 Ashland KY 41101-2876 |
| Mailing Address |
Po Box 2379 Ashland KY 41105-2379 |
| Practice Telephone | 6063244745 |
| Practice Fax Number | 6063244941 |
| Mailing Telephone | 6063244745 |
| Mailing Fax Number | 6063244941 |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2014-02-28 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
27105 | KY | Allopathic & Osteopathic Physicians |
| Y | 207RC0001X |
Internal Medicine Specialization: Clinical Cardiac Electrophysiology |
27105 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2138252 | 05 | |
| WV | 6020006000 | 05 | |
| KY | 64271059 | 05 | |
| KY | ANTHEM BCBS | 000000065461 | 01 |
| Street Address |
613 23RD ST STE 230 |
| City | ASHLAND |
| State | KY |
| Zip Code | 41101-2876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356330732 | Zane A Darnell | Internal Medicine | 613 23rd St, Ste 230, Ashland, KY 41101-2876 | 2005-10-18 |
| 1396189437 | Jeffrey Thomas Jenkins | Internal Medicine | 613 23rd St, Ashland, KY 41101-2878 | 2013-04-19 |
| 1740578301 | Stephanie Hutchison Md Psc | Obstetrics & Gynecology | 613 23rd St, Suite 130, Ashland, KY 41101-2878 | 2011-07-18 |
| 1346539541 | Kentucky Heart Institute | Radiology | 613 23rd St, Suite 140, Ashland, KY 41101-2878 | 2011-03-29 |
| 1104129238 | Diana Sue King | Nurse Practitioner | 613 23rd St, Suite 230, Ashland, KY 41101-2878 | 2010-12-12 |
| 1497083539 | Kings Daughters Medical Specialties Inc | Otolaryngology | 613 23rd St, Ste 420, Ashland, KY 41101-2878 | 2009-12-01 |
| 1235365537 | Kentucky Heart Institute Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 613 23rd St, Suite 210, Ashland, KY 41101-2878 | 2009-06-02 |
| 1053559617 | Kentucky Heart Institute | Surgery | 613 23rd St, Suite G-10, Ashland, KY 41101-2878 | 2009-02-04 |
| 1679710982 | Brittany R Stewart | Physician Assistant | 613 23rd St, Suite 340, Ashland, KY 41101-2878 | 2009-01-09 |
| 1154571172 | Mardini & Associates Md, Psc | Internal Medicine | 613 23rd St, Suite 120, Ashland, KY 41101-2878 | 2008-09-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588217947 | Aim Wellness LLC | Family Medicine | 844 Central Avenue, Ashland, KY 41101 | 2019-07-24 |
| 1306309067 | Ccc Management, LLC | Durable Medical Equipment & Medical Supplies | 1237 Carter Ave, Ashland, KY 41101 | 2019-04-10 |
| 1366925505 | Samantha Manci | Pharmacist | 2201 Lexington Ashland, Ashalnd, KY 41101 | 2018-09-13 |
| 1174068662 | Lea Ann Reeves-gollihue | Counselor | 1701 Central Ave., Ste. 250, Ashland, KY 41101 | 2016-12-20 |
| 1245786078 | Lindsay Marie Hagerman | Respiratory Therapist, Registered | 2413 Bradley Drive, Ashland, KY 41101 | 2016-08-31 |
| 1033572540 | A Center 4 Change | Psychologist | 5900 Us 60 W, Suite B, Ashland, KY 41101 | 2016-04-01 |
| 1013301159 | Precision Analysis Lab, LLC | Clinical Medical Laboratory | 101 17th Street, Ashland, KY 41101 | 2015-03-26 |
| 1639518574 | Steven Wayne Ledford Jr. | Dentist | 2301 Lexington Ave Ste 120, Ashland, KY 41101 | 2013-06-24 |
| 1528405875 | Brittani Kay Dingess | Pediatrics | 100 Ashland Dr, Ste 102, Ashland, KY 41101 | 2013-05-28 |
| 1770813487 | Paula Jean Hogsten | Clinical Nurse Specialist | 432 - 16th Street, Suite B- Tri State Nephrology, Ashland, KY 41101 | 2009-12-31 |
| Find all providers in zip 41101 | ||||
| Taxonomy Code | 207RC0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Clinical Cardiac Electrophysiology |
| A field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689837353 | Ola Khraisha | Internal Medicine | 613 23rd St St 230, Ashland, KY 41101 | 2008-07-03 |
| 1417203001 | Pratap Singh | Internal Medicine | 613 23rd St Ste 230, Ashland, KY 41101-2868 | 2012-08-01 |
| 1134484892 | Kings Daughters Medical Specialties Inc. | Internal Medicine | 613 23rd St Ste 210, Ashland, KY 41101-2868 | 2012-07-09 |
| 1578729109 | Kentucky Heart Institute | Internal Medicine | 613 23rd St, Suite 230, Ashland, KY 41101-2878 | 2008-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407065279 | Medical Center Cardiologists, Psc | Internal Medicine | 534 Fairway Dr, Brandenburg, KY 40108-1222 | 2007-05-21 |
| 1538100995 | Ohio Valley Heartcare Inc | Internal Medicine | 914 N Elm St, Henderson, KY 42420-2711 | 2006-06-09 |
| 1285622779 | Cardiac Care Center of Louisville, Pllc | Internal Medicine | 100 Mallard Creek Rd, Suite 150, Louisville, KY 40207-4194 | 2005-10-10 |
| 1336144401 | Christopher Lars Johnsrude | Internal Medicine | 411 E Chestnut St # 5a, Louisville, KY 40202-1713 | 2005-06-16 |
| 1841763380 | Deaconess Specialty Physicians, Inc | Internal Medicine | 3346 Professional Park, Owensboro, KY 42303-4551 | 2019-01-08 |
| 1124522750 | Deaconess Specialty Physicians, Inc | Internal Medicine | 1300 Merritt Dr Ste 110, Henderson, KY 42420-2788 | 2018-03-20 |
| 1114421740 | Deaconess Specialty Physicians, Inc | Internal Medicine | 2200 E Parrish Ave Bldg A, Owensboro, KY 42303 | 2018-03-20 |
| 1053810036 | Owensboro Health Medical Group, Inc. | Internal Medicine | 1201 Pleasant Valley Rd, Owensboro, KY 42303-9811 | 2018-02-06 |
| 1639510753 | Mohammed Abdul Haseeb Al-yafi I | Internal Medicine | Uk Gill Heart Institute, 800 Rose St, Lexington, KY 40536-0294 | 2013-07-17 |
| 1710115175 | Sjl Physician Management Services Inc. | Internal Medicine | 1210 W 5th St, London, KY 40741-2112 | 2009-06-24 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.