Vicki Lyndall Van, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

029811 Issued in GA

Practice address

747 S Hill St
Griffin, GA 30224-4830

Phone

(770) 228-5407

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vicki Lyndall Conklin Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

General Practice

Education

Eastern Virginia Medical School, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Privia Medical Group of Georgia LLCGroup PAC ID 4284951542, 454 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Spalding Medical Center Hospital, Griffin, GA, CCN 110031
• Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
• Direct secure messaging: vicki.van.1@8042.direct.athenahealth.com

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.

• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Fayetteville, GA
  • NPI 1013313857

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Privia Medical Group of Georgia LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1356907273

  Family Medicine

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Piedmont Henry Hospital, Inc.

  • General Acute Care Hospital
  • Stockbridge, GA
  • NPI 1225034333
  Care Compare affiliation
• Wellstar Spalding Regional Hospital, Inc

  • General Acute Care Hospital
  • Griffin, GA
  • NPI 1972535318
  Care Compare affiliation

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124181086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 CLUB DR",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302237125",
            "telephone_number": "770-228-5407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "747 S HILL ST",
            "city": "GRIFFIN",
            "state": "GA",
            "postal_code": "302244830",
            "telephone_number": "770-228-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN",
        "first_name": "VICKI",
        "middle_name": "LYNDALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "029811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52023548",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKI",
            "last_name": "CONKLIN",
            "middle_name": "LYNDALL",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Hardik R Vachhani
• Erin Valeich, OTR
• Jacqueline Valme, OCCUPATIONAL THERAPI
• Antonius Johannes Van Scherpenseel, PT, MTC, OCS
• David Arthur Van, M.D.
• Whitney Varner, PP,BS
• Vascular Wellness Center
• Amanda J Vaughn, PHARM D
• Michael Allen Vaughn, PT, CSCS
• Glenn Ashleigh Veal

• Family Medicine Physician in Griffin, GA
• Providers in Griffin, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• 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.