Bradley Dean Vandyke, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

0104001184 Issued in VA

Practice address

1779 Lovers Gap Road
Vansant, VA 24656

Phone

(276) 597-8387

Fax

(276) 597-2154

NPI assigned

Feb 14, 2006

Last updated

Nov 28, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Buchanan General Hospital Inc

  dba Mountain Air Medical Clinic

  • Rural Health Clinic/Center
  • Grundy, VA
  • NPI 1831943380

  Corporate Director

  CMS ownership
• Buchanan General Hospital Inc

  dba Mountain View Medical Clinic

  • Rural Health Clinic/Center
  • Grundy, VA
  • NPI 1891402228

  Corporate Director

  CMS ownership
• Buchanan General Hospital, Inc

  • General Acute Care Hospital
  • Grundy, VA
  • NPI 1225036346

  Corporate Director

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vandyke Chiropractic PC

  • Sports Physician Chiropractor
  • Vansant, VA
  • NPI 1649490855
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322438400000",
    "number": "1013981356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 855",
            "city": "VANSANT",
            "state": "VA",
            "postal_code": "246560855",
            "telephone_number": "276-597-8387",
            "fax_number": "276-597-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 LOVERS GAP ROAD",
            "city": "VANSANT",
            "state": "VA",
            "postal_code": "24656",
            "telephone_number": "276-597-8387",
            "fax_number": "276-597-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "BRADLEY",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2011-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104001184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600037000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Traci Leeann Rowlett, FNP-C
• Jane Adele Seymour, COTA/L
• Barbara L Shinall, FNP
• St. Charles Health Council Inc (Thompson Family Health Center)
• Vandyke Chiropractic PC
• Sandra Jean Vandyke, FNP
• Viers Hunt Broyles, & Brown, Inc. (Family Drug)
• Anita Renee Woolford, MSN, NP-C

• Sports Physician Chiropractor in Vansant, VA
• Providers in Vansant, VA by specialty
• Sports Physician Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.