Brian P Vandendries, NP

Primary specialty

Occupational Health Nurse PractitionerTaxonomy code 363LX0106X

License

NP-637 Issued in ID

Practice address

520 S Eagle Rd
Suite 2213
Meridian, ID 83642-6351

Phone

(208) 706-5447

Fax

(208) 706-5448

NPI assigned

Jan 23, 2007

Last updated

Sep 18, 2012By the provider in NPPES

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

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bvandendries9037@direct.slhs.org

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.

• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058
  NPD
• St Lukes Regional Medical Center

  dba St Lukes Meridian Medical Center

  • General Acute Care Hospital
  • Boise, ID
  • NPI 1770586794
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347926400000",
    "number": "1255485561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241",
            "telephone_number": "208-706-7500",
            "fax_number": "208-706-7501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S EAGLE RD",
            "address_2": "SUITE 2213",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836426351",
            "telephone_number": "208-706-5447",
            "fax_number": "208-706-5448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENDRIES",
        "first_name": "BRIAN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2012-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "ID",
            "license": "NP-637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valor Family Therapy
• Miranda Michelle Van Dam, CSFA
• Benjamin Alexander Van Hoogen, FNP-C
• Chelsea Marie Van Wagenen, RN, NTP, RWS
• Klaas Vanden Beld, NP
• Kayla Vander Stelt
• Dana L Vandergiessen, LCPC
• Nariana Vandeventer, MS
• Tamra Susanne Vanegas, MA, LPC, MAC
• Erin M Vanheel

• Occupational Health Nurse Practitioner in Meridian, ID
• Providers in Meridian, ID by specialty
• Occupational Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.