NPIMap

Individual provider Active NPI

Joshua Vanderwall, MD

  • Emergency Medicine Physician
  • Richland, MI
National Provider Identifier
1184079915
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
4301502346 Issued in MI
Practice address
8906 M 89
Richland, MI 49083-9540
Phone
(269) 286-7130
NPI assigned
Apr 29, 2016
Last updated
Aug 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301502346 MI Primary
Family Medicine Physician 207Q00000X 4301502346 MI

Addresses

Primary practice location

8906 M 89
Richland, MI 49083-9540

Mailing address

601 John Street
Box 39
Kalamazoo, MI 49007

Other practice location 1

7501 Riverside Pkwy
Tulsa, OK 74136-5056
Phone (918) 710-4200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct Bronson Healthcare Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AL, MI3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20171101003184 OK Practitioner - Family Practice 9234495532 Reassigns benefits to 1 organization
I20190909000485 AL Practitioner - Emergency Medicine 9234495532 Reassigns benefits to 2 organizations
I20200929003455 MI Practitioner - Emergency Medicine 9234495532 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Michigan State University College of Human Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vituity - Michigan Em PCGroup PAC ID 8022414010, 51 clinicians

Practice addresses (Care Compare)

321 E Harris St
Charlotte, MI 48813-1629
Phone (517) 543-1050

411 Naomi St
Plainwell, MI 49080-1222
Phone (269) 685-6811

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
St. John Physicians, Inc CurrentSince Nov 1, 2017 Accepting new patients
Island Medical Alabama LLC Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients
Vituity - Michigan Em PC Emergency Medicine CurrentSince Oct 1, 2021 Accepting new patients
St. John Physicians, Inc. Emergency Medicine Current Accepting new patients
Immh Scottsboro LLC Emergency Medicine CurrentSince Sep 29, 2019 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Vituity-Michigan Health Services PC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Vituity-Michigan Health Services PC Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients

Locations

1912 AL Highway 157
Cullman, AL 35058
Phone (256) 737-2496

380 Woods Cove Rd
Scottsboro, AL 35768
Phone (256) 218-3579

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

12420 Milestone Center Dr
Ste 200
Germantown, MD 20876
Phone (336) 509-7515

321 E Harris St
Charlotte, MI 48813
Phone (517) 541-5840

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

200 N Madison St
Marshall, MI 49068
Phone (269) 789-3921

411 Naomi St
Plainwell, MI 49080
Phone (269) 685-0700

4599 Towne Centre Rd
Saginaw, MI 48604
Phone (989) 497-3000

1705 E 19th St
Ste 302
Tulsa, OK 74104
Phone (918) 748-7585

Organizations & group practices 9

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1184079915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN STREET",
            "address_2": "BOX 39",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "49007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8906 M 89",
            "city": "RICHLAND",
            "state": "MI",
            "postal_code": "490839540",
            "telephone_number": "269-286-7130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7501 Riverside Pkwy",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741365056",
            "country_code": "US",
            "telephone_number": "918-710-4200",
            "fax_number": "918-403-6331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERWALL",
        "first_name": "JOSHUA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-29",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301502346",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301502346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "affiliationName": "Bronson Healthcare Group",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Richland, MI

Sources for this page

Verify at the official NPI Registry.