Vandalia Health, PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

VANDALIA HEALTH, PLLC

Practice address

2304 Wyoming CT
Sartell, MN 56377-4562

Phone

(320) 200-9547

NPI assigned

Jan 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Cody W Wendlandt, MDNPI 1972915882

Title

Medical Director

Phone

(320) 200-9547

Specialties & licenses 1

Addresses

Other names 2

• Dr. Green Doing business as
• Southdale Addiction Clinic Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cody Wayne Wendlandt, MD

  • Family Medicine Physician
  • Sartell, MN
  • NPI 1972915882
  NPD Authorized official

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1154839660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2304 WYOMING CT",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774562",
            "telephone_number": "320-200-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2304 WYOMING CT",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563774562",
            "telephone_number": "320-200-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDALIA HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "WENDLANDT",
        "authorized_official_first_name": "CODY",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "320-200-9547",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Green",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southdale Addiction Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rachael Tuve Stenstrom
• Alexander Twohy
• Ben Edet Ukitetuh
• Unbound Psychiatry PLC
• Jessica Marie Vagle, APRN CNS-BC FNP-BC
• Philip H Vanderstoep, M.D.
• Stephen D Vang, PA-C
• Brent David Venables, D.C.
• Sofia Margaret Villalobos
• Alan J. Voegele, PA-C

• Clinic/Center in Sartell, MN
• Providers in Sartell, MN by specialty
• Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.