Mr Edward Roy Vanderbilt, MSN, APRN, FNP-C in Winston Salem, NC

Mr Edward Roy Vanderbilt, MSN, APRN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Winston Salem, North Carolina. He graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Patheous Medical Pllc and his current practice location is 1304 Ashley Sq, Winston Salem, North Carolina. You can reach out to his office (for appointments etc.) via phone at (336) 817-9268.

Mr Edward Roy Vanderbilt is licensed to practice in North Carolina (license number 5013618) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1417553942.

Contact Information

	Mr Edward Roy Vanderbilt, MSN, APRN, FNP-C
	1304 Ashley Sq, Winston Salem, NC 27103-2919
	(336) 817-9268
	(336) 396-8041

Map and Direction

Provider's Profile

Full Name	Mr Edward Roy Vanderbilt
Gender	Male
Speciality	Nurse Practitioner
Experience	5 Years
Location	1304 Ashley Sq, Winston Salem, North Carolina
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Edward Roy Vanderbilt graduated from nursing school in 2020

NPI Data:

NPI Number: 1417553942
Provider Enumeration Date: 12/09/2020
Last Update Date: 03/11/2025

Medicare PECOS Information:

PECOS PAC ID: 8729495502
Enrollment ID: I20210323000222

Medical Identifiers

Medical identifiers for Mr Edward Roy Vanderbilt such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417553942	NPI	-	NPPES
1417553942	Medicaid	NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	5013618 (North Carolina)	Secondary
363LF0000X	Nurse Practitioner - Family	5013618 (North Carolina)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Patheous Medical Pllc	8921458720	19

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. Mr Edward Roy Vanderbilt allows following entities to bill medicare on his behalf.

Entity Name	Quick Doc Partners Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003407586 PECOS PAC ID: 7315353596 Enrollment ID: O20210312001694

Entity Name	Patheous Medical Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366121527 PECOS PAC ID: 8921458720 Enrollment ID: O20240118004655

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. Mr Edward Roy Vanderbilt 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 Address	Practice Location Address
Mr Edward Roy Vanderbilt, MSN, APRN, FNP-C 120 Ivorhing Ct, Kernersville, NC 27284-6335 Ph: (336) 817-9268	Mr Edward Roy Vanderbilt, MSN, APRN, FNP-C 1304 Ashley Sq, Winston Salem, NC 27103-2919 Ph: (336) 817-9268

Reviews and Comments

Nurse Practitioner Nurses in Winston Salem, NC

Kaila Haskins, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2085 Frontis Plaza Blvd, Winston Salem, NC 27103 Phone: 704-316-4136 Fax: 704-417-4814
Cora Robbins, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2025 Frontis Plaza Blvd Ste 100, Winston Salem, NC 27103 Phone: 336-718-6199 Fax: 336-718-6190
Mrs. Joy Lianne Justice, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2085 Frontis Plaza Blvd, Winston Salem, NC 27103 Phone: 704-316-4136 Fax: 704-417-4814
Lillykutty Abraham Modoor, NURSE PRACTITIONER Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 650 Highland Ave Ste 100, Winston Salem, NC 27101 Phone: 336-607-8523 Fax: 336-773-0916
Dr. Marie Huffmaster Thomas, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3333 Silas Creek Pkwy, Winston Salem, NC 27103 Phone: 336-718-5000
Jennifer Adams, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1medical Center Blvd, Winston Salem, NC 27157 Phone: 336-716-2878
Deborah Krist Potticary, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3333 Silas Creek Pkwy, Winston Salem, NC 27103 Phone: 336-718-7041 Fax: 336-718-9622

Mr Edward Roy Vanderbilt, MSN, APRN, FNP-C - Medicare Nurse Practitioner in Winston Salem, NC