Healthcare Provider Details

I. General information

NPI: 1528142429
Provider Name (Legal Business Name): VANDERBILT UNIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 THE VANDERBILT CLINIC
NASHVILLE TN
37232-5100
US

IV. Provider business mailing address

4163 VILLAGE AT VANDERBILT
NASHVILLE TN
37232-8678
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-3000
  • Fax:
Mailing address:
  • Phone: 615-322-3573
  • Fax: 615-936-6095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: KAE EDINGTON
Title or Position: DIRECTOR, PROVIDER SUPPORT SERVICES
Credential:
Phone: 615-936-0471