Orville Keith Vandergriend, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD00010361 Issued in WA

Practice address

3104 Squalicum Pkwy
Suite 101
Bellingham, WA 98225-1941

Phone

(360) 733-2557

Fax

(360) 733-4674

NPI assigned

Jan 10, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ovandergriend3939@direct.peacehealth.org

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

• Parkway General Surgeons

  • Specialist
  • Bellingham, WA
  • NPI 1306992037
  Medicare reassignment NPD
• Peacehealth

  • Internal Medicine Physician
  • Bellingham, WA
  • NPI 1356309553
  Medicare reassignment NPD
• Parkway Surgical Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Bellingham, WA
  • NPI 1346396082
  NPD (past)

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1073662508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 SQUALICUM PKWY",
            "address_2": "SUITE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251941",
            "telephone_number": "360-733-2557",
            "fax_number": "360-733-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 SQUALICUM PKWY",
            "address_2": "SUITE 101",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982251941",
            "telephone_number": "360-733-2557",
            "fax_number": "360-733-4674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERGRIEND",
        "first_name": "ORVILLE",
        "middle_name": "KEITH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WA",
            "license": "10361",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00010361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1069509",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1073662508",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRIME VICTIMS (PEACEHEALTH)",
            "identifier": "82107",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD (PEACEHEALTH)",
            "identifier": "0146VA",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keith J Vander Griend, M.D.
• Joshua P Vander Wiele, LMHCA
• Janine Vander Yacht, PTA
• Carletta Mary Brown Vanderbilt, M.D.
• Tosha Vanderburg
• Scott Daniel Vanderleest, M.D.
• Mark Vandervort, PA-C
• Catherine Vandiver, CCC-SLP
• Richard Vankolken, MD
• Jessica Irene Vanleeuwen, LMT

• Surgery Physician in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.