Organization Active NPI

Gary M Van Deventer MD

  • Gastroenterology Physician
  • Santa Barbara, CA
National Provider Identifier
1053508721
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GARY M VAN DEVENTER MD
Practice address
221 W Pueblo St
Suite B
Santa Barbara, CA 93105-6814
Phone
(805) 563-0024
Fax
(805) 563-1454
NPI assigned
Sep 26, 2007
Last updated
Aug 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Authorized official

Name
Dr. Gary M Van Deventer, MDNPI 1285628933
Title
President
Phone
(805) 963-3336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

221 W Pueblo St
Suite B
Santa Barbara, CA 93105-6814

Mailing address

PO Box 50706
Santa Barbara, CA 93150-0706
Phone (805) 963-3336

Other identifiers 1

IdentifierTypeStateIssuer
100004009OtherCARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

221 W Pueblo St
Ste B
Santa Barbara, CA 93105
Phone (805) 563-0024

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1053508721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 50706",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931500706",
            "telephone_number": "805-963-3336",
            "fax_number": "805-564-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W PUEBLO ST",
            "address_2": "SUITE B",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931056814",
            "telephone_number": "805-563-0024",
            "fax_number": "805-563-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY M VAN DEVENTER MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "VAN DEVENTER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-963-3336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "100004009",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Barbara, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.