Basic Information
| Provider Information | |||||||||
| NPI: | 1396882205 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | VANDERBILT UNIVERSITY MEDICAL CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3841 GREEN HILLS VILLAGE DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372152691 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1211 MEDICAL CENTER DRIVE | ||||||||
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| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372320004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153225000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/31/2007 | ||||||||
| LastUpdateDate: | 03/31/2022 | ||||||||
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| AuthorizedOfficialLastName: | SIMMONS | ||||||||
| AuthorizedOfficialFirstName: | ANGELA | ||||||||
| AuthorizedOfficialMiddleName: | L | ||||||||
| AuthorizedOfficialTitleorPosition: | VP FINANCE-REVENUE AND REIMBURSEMEN | ||||||||
| AuthorizedOfficialTelephone: | 6159368877 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/31/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | N | Hospital Units | Psychiatric Unit | 282N00000X | N | Hospitals | General Acute Care Hospital | 282NC2000X | N | Hospitals | General Acute Care Hospital | Children | 283Q00000X | N | Hospitals | Psychiatric Hospital | 291U00000X | N | Laboratories | Clinical Medical Laboratory | 3416A0800X | N | Transportation Services | Ambulance | Air Transport | 3416L0300X | N | Transportation Services | Ambulance | Land Transport | 282N00000X | 0000000027 | TN | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | 044-0039 | 05 | TN | MEDICAID |