Jessica M Vanderham (NPI# 1285143891, PAC ID# 5991071409) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1285143891 |
| PAC ID by PECOS | 5991071409 |
| Professional Enrollment ID | I20171030000585 |
| Full Name | Jessica M Vanderham |
| Organization Legal Name | WAGNER COMMUNITY MEMORIAL HOSPITAL |
| Address |
513 3rd St Sw Wagner SD 57380-9675 |
| Gender | F |
| Graduation Year | 2017 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 3577459700 |
| Number of Group Practice Members | 10 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 431315 | WAGNER COMMUNITY MEMORIAL HOSPITAL - CAH |
| 431329 | SANFORD CHAMBERLAIN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 513 3rd St Sw, Wagner, SD 57380-9675 | WAGNER COMMUNITY MEMORIAL HOSPITAL |
| Organization Legal Name | WAGNER COMMUNITY MEMORIAL HOSPITAL |
| Physicians | 11 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lindsey Rae Nedved | Nurse Practitioner | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Carol Lee Stewart | Nurse Practitioner | Wagner Community Memorial Hospital | 513 Sw 3rd St, Wagner, SD 57380-9675 |
| Ryan Kocer | Nurse Practitioner | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Jeffrey D Pinter | Family Medicine | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Jordan Carl Weber | Physician Assistant | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Mikaela J Koenig | Family Medicine | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Theresa A Petersen | Nurse Practitioner | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Lindsey A Barthel | Nurse Practitioner | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Teresa A Marts | Family Medicine | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Karen Schleiger | Physician Assistant | Wagner Community Memorial Hospital | 513 Sw 3rd St, Wagner, SD 57380-9675 |
| Street Address |
513 3RD ST SW |
| City | WAGNER |
| State | SD |
| Zip | 57380-9675 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lindsey Rae Nedved | Nurse Practitioner | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Ryan Kocer | Nurse Practitioner | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Jeffrey D Pinter | Family Medicine | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Jordan Carl Weber | Physician Assistant | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Mikaela J Koenig | Family Medicine | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Theresa A Petersen | Nurse Practitioner | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Lindsey A Barthel | Nurse Practitioner | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Teresa A Marts | Family Medicine | Wagner Community Memorial Hospital | 513 3rd St Sw, Wagner, SD 57380-9675 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Blandine B Pierre | General Practice | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Jaime Aguilar | Physician Assistant | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Pedro H Ibarra Perocier | General Practice | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Antonio C Padilla Cedo | General Practice | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Julie K Williams | Optometry | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Grisel Rodriguez Diaz | General Practice | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Irwin W Fish | Physician Assistant | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Gretchen M Esplund | Family Practice | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Rishi Patel | General Practice | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Michelle L Powers | Physician Assistant | Wagner Indian Health Service Health Center | 111 Washington Ave Nw, Wagner, SD 57380-4300 |
| Find all physicians in zip 57380 | |||
| City | WAGNER |
| Zip Code | 57380 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | WAGNER + NURSE PRACTITIONER |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.