Individual provider Active NPI

Cathleen E Vandergriff, M.D

  • Family Medicine Physician
  • Broken Arrow, OK
National Provider Identifier
1306967088
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30144 Issued in OK
Practice address
2643 E Albany St Apt C
Broken Arrow, OK 74014-4634
Phone
(918) 421-1341
NPI assigned
Apr 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30144 OK Primary

Addresses

Primary practice location

2643 E Albany St Apt C
Broken Arrow, OK 74014-4634

Mailing address

2643 E Albany St Apt C
Broken Arrow, OK 74014-4634
Phone (918) 421-1341

Other identifiers 1

IdentifierTypeStateIssuer
200582760AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150416001993 OK Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 0648294470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Peripheral Vascular Disease
Education
University of Arkansas College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vohra Wound Physicians of FL LLCGroup PAC ID 6406039882, 73 clinicians

Practice addresses (Care Compare)

10912 E 14TH St
Tulsa, OK 74128-4845
Phone (918) 438-2440

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue518
Removal of skin lesions25
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vohra Wound Physicians of FL, LLC Family Medicine CurrentSince Jan 22, 2018 Accepting new patients
Vohra Wound Physicians of FL, LLC Family Medicine CurrentSince Jan 22, 2018 Accepting new patients
Designing Health PA Family Medicine PastSince Aug 15, 2008 Accepting new patients

Locations

3601 SW 160th Ave
Ste 250
Miramar, FL 33027
Phone (305) 866-9951

10912 E 14th St
Tulsa, OK 74128
Phone (918) 438-2440

Organizations & group practices 3

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": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1306967088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2643 E ALBANY ST APT C",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740144634",
            "telephone_number": "918-421-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2643 E ALBANY ST APT C",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740144634",
            "telephone_number": "918-421-1341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERGRIFF",
        "first_name": "CATHLEEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "30144",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200582760A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.