Bruce J Vanderkooi, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19043 Issued in IA

Practice address

620 Northwestern Dr
Storm Lake, IA 50588-2935

Phone

(712) 732-5030

NPI assigned

Feb 2, 2006

Last updated

Sep 25, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Floyd County Memorial Hospital Commission

  • Critical Access Hospital
  • Charles City, IA
  • NPI 1265402390

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190678400000",
    "number": "1114999463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 N 9TH ST",
            "address_2": "SUITE A",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505013909",
            "telephone_number": "515-574-6890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 NORTHWESTERN DR",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505882935",
            "telephone_number": "712-732-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERKOOI",
        "first_name": "BRUCE",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2007-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "19043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trinity Regional Medical Center (Unitypoint Clinic Family Health Center - Storm Lake)
• Troy D Ivey DO PLC
• United Community Health Center Inc.
• Unitypoint at Home
• Julie L. Vails, M.D.
• Jorge Luis Vendrell Sr., MD
• Vision Care Associates PC
• Wal-Mart Stores, Inc. (Vision Center 30-1526)
• Walgreen Co (Walgreens #11330)
• Walmart Inc. (Walmart Pharmacy 10-1526)

• Family Medicine Physician in Storm Lake, IA
• Providers in Storm Lake, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.