Mark Vandervort, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

60055369 Issued in WA

Practice address

4280 Meridian St
Ste 120
Bellingham, WA 98226-6464

Phone

(360) 734-4300

NPI assigned

Sep 21, 2007

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)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/CEBACA/Endpoint/CEBACA

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.

• Care Medical Group, Inc. P.S.

  • Family Medicine Physician
  • Bellingham, WA
  • NPI 1346261500
  NPD (past)

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1124214358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 MERIDIAN ST",
            "address_2": "STE 120",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266464",
            "telephone_number": "360-734-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 MERIDIAN ST",
            "address_2": "STE 120",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982266464",
            "telephone_number": "360-734-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVORT",
        "first_name": "MARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-21",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "60055369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janine Vander Yacht, PTA
• Carletta Mary Brown Vanderbilt, M.D.
• Tosha Vanderburg
• Orville Keith Vandergriend, M.D.
• Scott Daniel Vanderleest, M.D.
• Catherine Vandiver, CCC-SLP
• Richard Vankolken, MD
• Jessica Irene Vanleeuwen, LMT
• Trisha Joy Vanmersbergen, LMP
• John P Vanmieghem, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.