Individual provider Active NPI

Rachel Vandyke, BC-AGACNP

  • Acute Care Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1235502444
Registry record updated Nov 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
3009881 Issued in KY
Practice address
800 Rose St
Lexington, KY 40536-0001
Phone
(859) 323-8072
NPI assigned
Nov 10, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 3009881 KY Primary

Addresses

Primary practice location

800 Rose St
Lexington, KY 40536-0001

Mailing address

823 Spyglass LN
Lexington, KY 40509-2104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200414002720 MI Practitioner - Nurse Practitioner 9335440015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

854 Washington Ave
150 Pulmonary and Sleep Medicine
Holland, MI 49423-7147
Phone (616) 395-2853

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3009881KYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital Current Accepting new patients
Holland Community Hospital CurrentSince Mar 1, 2020 Accepting new patients
Holland Community Hospital CurrentSince Mar 1, 2020 Accepting new patients
Holland Community Hospital Past Accepting new patients

Locations

854 Washington Ave
Ste 150
Holland, MI 49423
Phone (616) 355-3863

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

577 Michigan Ave
Ste 101
Holland, MI 49423
Phone (616) 393-2190

854 Washington Ave
Ste 330
Holland, MI 49423
Phone (616) 355-3926

854 Washington Ave
Bldg A
Holland, MI 49423

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1447113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447113600000",
    "number": "1235502444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 SPYGLASS LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405360001",
            "telephone_number": "859-323-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "RACHEL",
        "credential": "BC-AGACNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-10",
        "last_updated": "2015-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "KY",
            "license": "3009881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.