Todd Leon Vandenberg
PROVIDENCE PHYSICIAN PRACTICES, LLC


Address: 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Phone: 8032565300

Todd Leon Vandenberg (NPI# 1558367623, PAC ID# 9830170489) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.

Physician Overview

Nation Provider ID (NPI) 1558367623
PAC ID by PECOS 9830170489
Professional Enrollment ID I20110407000709
Full Name Todd Leon Vandenberg
Organization Legal Name PROVIDENCE PHYSICIAN PRACTICES, LLC
Address 120 Gateway Corp Blvd
Columbia
SC 29203-9611
Phone Number 8032565300
Gender M
Medical School TULANE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year 1993
Primary Specialty UROLOGY
Group Practice PAC ID 9638475627
Number of Group Practice Members 30
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
420026 PROVIDENCE HEALTH
420086 PALMETTO HEALTH BAPTIST

Other Locations

Address Phone Organization
120 Gateway Corp Blvd, Columbia, SC 29203-9611 8032565300 PROVIDENCE PHYSICIAN PRACTICES, LLC
2001 Laurel St, Suite 300, Columbia, SC 29204-1018 8032542786 PROVIDENCE PHYSICIAN PRACTICES, LLC

Organization Information

Organization Legal Name PROVIDENCE PHYSICIAN PRACTICES, LLC
Physicians 39

Physicians with the same organization

Name Specialty Organization Address
Sherri L Mccain Nurse Practitioner Providence Physician Practices, LLC 2351 Augusta Hwy, Lexington, SC 29072-2213
Nusrat Ul Shafi Family Medicine Providence Physician Practices, LLC 114 Gateway Corporate Blvd, Suite 350, Columbia, SC 29203-9785
Robert P Zurcher Cardiac Surgery Providence Physician Practices, LLC 2750 Laurel St, Suite 305, Columbia, SC 29204-2025
Donna S Cambron Nurse Practitioner Providence Physician Practices, LLC 2435 Forest Dr, Columbia, SC 29204-2026
John P Sutton Iii Cardiac Surgery Providence Physician Practices, LLC 2750 Laurel St, Suite 305, Columbia, SC 29204-2025
Benedict R Studnicka Internal Medicine Providence Physician Practices, LLC 2001 Laurel St, Suite 300, Columbia, SC 29204-1018
Whitney P Pitts Nurse Practitioner Providence Physician Practices, LLC 2750 Laurel St, Suite 303, Columbia, SC 29204-2025
Charis P Taylor Internal Medicine Providence Physician Practices, LLC 2001 Laurel St, Suite 300, Columbia, SC 29204-1018
Kelly Cho Harris General Surgery Providence Physician Practices, LLC 2750 Laurel St, Suite 200aandb, Columbia, SC 29204-2038
Frederic A Smith Internal Medicine Providence Physician Practices, LLC 2750 Laurel St, Suite 303, Columbia, SC 29204-2025

Office Location

Street Address 120 GATEWAY CORP BLVD
City COLUMBIA
State SC
Zip 29203-9611

Physicians in the same location

Name Specialty Organization Address
Ryan S Slife Emergency Medicine Broad River Physicians Group, LLC 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Torrey Phillip Poholsky Hospitalist Apogee Medical Group South Carolina 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Liubou Simonovich Physician Assistant Apogee Medical Group South Carolina 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Rose Basnyat Hospitalist Apogee Medical Group South Carolina 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Debra J Prosser Nurse Practitioner Broad River Physicians Group, LLC 120 Gateway Corp Blvd, Columbia, SC 29203-9611
David E Krusling Emergency Medicine Broad River Physicians Group, LLC 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Colin Widener Hospitalist Apogee Medical Group South Carolina 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Vernon Scott Carroll Sr. Emergency Medicine Broad River Physicians Group, LLC 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Jerry W Robinson Internal Medicine Apogee Medical Group South Carolina 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Holly K Smith Internal Medicine Providence Physician Practices, LLC 120 Gateway Corp Blvd, Columbia, SC 29203-9611
Find all physicians in the same address

Physicians in the same zip code

Name Specialty Organization Address
Zachary Logan Hardy Emergency Medicine Prisma Health Midlands 14 Medical Park Rd, Suite 350, Columbia, SC 29203
Robin B Welsh Psychiatry University Pediatrics 14 Medical Park, Suite 400, Columbia, SC 29203
Lawrence K Siegel Pediatric Medicine University Pediatrics 9 Medical Park, Columbia, SC 29203
Ronnie W Neuberg Pediatric Medicine Palmetto Health 7 Medical Park, Suite 203, Columbia, SC 29203
Melanie Blackburn Pediatric Medicine University Pediatrics 14 Medical Park, Columbia, SC 29203
Julia B Ballance Pediatric Medicine University Pediatrics 14 Medical Park, Columbia, SC 29203
Matthew M Wienecke Cardiovascular Disease (cardiology) University Pediatrics 9 Medical Park, Suite 110, Columbia, SC 29203
Charles W Derrick Jr. Pediatric Medicine University Pediatrics 9 Medical Park, Columbia, SC 29203
Whitney Brown Endocrinology University Pediatrics 9 Medical Park, Columbia, SC 29203
Stacey M Humphreys Critical Care (intensivists) Palmetto Health 7 Medical Park, Suite 203, Columbia, SC 29203
Find all physicians in zip 29203

Competitor

Search similar physicians

City COLUMBIA
Zip Code 29203
Specialty UROLOGY
City + Specialty COLUMBIA + UROLOGY

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Dataset Information

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.

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