Active NPI
John G Vanderford, D.O.
- Emergency Medical Services (Emergency Medicine) Physician
- Southfield, MI
National Provider Identifier
1093755209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medical Services (Emergency Medicine) Physician
- License
- 5101010489
- Practice address
- 16001 W 9 Mile Rd
Southfield, MI 48075-4818 - Phone
- (248) 849-3000
- NPI assigned
- Jun 7, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician | 207PE0004X | 5101010489 | MI | Primary |
Addresses
Primary practice location
16001 W 9 Mile Rd
Southfield, MI 48075-4818
Mailing address
212 W Lincoln St
Birmingham, MI 48009-1960
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 113374659 | Medicaid | MI | |
| 5101010489 | Other | MI | MEDICAL LICENSE |
| 114357957 | Medicaid | MI | |
| 114298954 | Medicaid | MI | |
| JV010489 | Other | MI | BC/BS OF MICHIGAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359763200000",
"number": "1093755209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 W LINCOLN ST",
"city": "BIRMINGHAM",
"state": "MI",
"postal_code": "480091960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16001 W 9 MILE RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480754818",
"telephone_number": "248-849-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERFORD",
"first_name": "JOHN",
"middle_name": "G",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-07",
"last_updated": "2013-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "207PE0004X",
"taxonomy_group": "",
"desc": "Emergency Medicine, Emergency Medical Services",
"state": "MI",
"license": "5101010489",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "113374659",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "5101010489",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114357957",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114298954",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF MICHIGAN",
"identifier": "JV010489",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.