Jessica M Vanderham, CNP - Medicare Nurse Practitioner in Wagner, SD

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Jessica M Vanderham, CNP is a medicare enrolled "Nurse Practitioner - Family" in Wagner, South Dakota. She graduated from nursing school in 2017 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Lake Norman Emergency Medical Associates Llc, Lake Norman Inpatient Specialists and her current practice location is 513 3rd St Sw, Wagner, South Dakota. You can reach out to her office (for appointments etc.) via phone at (605) 384-3611.

Jessica M Vanderham is licensed to practice in North Carolina (license number 5017905) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1285143891.

Contact Information

Jessica M Vanderham, CNP
513 3rd St Sw,
Wagner, SD 57380-9675
(605) 384-3611
Not Available

Map and Direction




Provider's Profile

Full NameJessica M Vanderham
GenderFemale
SpecialityNurse Practitioner
Experience8 Years
Location513 3rd St Sw, Wagner, South Dakota
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jessica M Vanderham graduated from nursing school in 2017
  NPI Data:
  • NPI Number: 1285143891
  • Provider Enumeration Date: 09/26/2017
  • Last Update Date: 04/16/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 5991071409
  • Enrollment ID: I20230818002054

Medical Identifiers

Medical identifiers for Jessica M Vanderham such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1285143891NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family CP001277 (South Dakota)Secondary
363LF0000XNurse Practitioner - Family 5017905 (North Carolina)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Lake Norman Regional Medical CenterMooresville, NCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lake Norman Emergency Medical Associates Llc549692797210
Lake Norman Inpatient Specialists73152413388

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica M Vanderham allows following entities to bill medicare on her behalf.
Entity NameLake Norman Emergency Medical Associates Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1053690560
PECOS PAC ID: 5496927972
Enrollment ID: O20111005000200
Entity NameLake Norman Inpatient Specialists
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1851766885
PECOS PAC ID: 7315241338
Enrollment ID: O20160210002905
Entity NamePiedmont Triad Physicians Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295206464
PECOS PAC ID: 6406197334
Enrollment ID: O20190403000344
Entity NameKernersville Emergency Group, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750852034
PECOS PAC ID: 3375885429
Enrollment ID: O20190422001205
Entity NameTanglewood Park Physicians Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093286379
PECOS PAC ID: 3476895129
Enrollment ID: O20190429001041
Entity NameTheoria Medical
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1609362375
PECOS PAC ID: 5395098339
Enrollment ID: O20210429000604

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica M Vanderham is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice 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

Reviews and Comments


Nurse Practitioner Nurses in Wagner, SD

Lindsey Nedved, NP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 513 3rd St Sw, Wagner, SD 57380
Phone: 605-384-3611    
Carol Lee Stewart, DNP, APRN, CNP
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: Accepting Medicare Assignments
Practice Location: 513 3rd St Sw, Wagner, SD 57380
Phone: 605-384-3611    
Jazmyn Soukup, DNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 513 3rd St Sw, Wagner, SD 57380
Phone: 605-384-3611    
Brooke Lynn Plooster, CNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
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    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.