Individual provider Active NPI

Peggy A Vandyke, MSN, APRN, BC

  • Family Nurse Practitioner
  • Sedalia, MO
National Provider Identifier
1316130032
Registry record updated Aug 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
093560 Issued in MO
Practice address
3131 Brianna Blvd
Sedalia, MO 65301-2285
Phone
(660) 826-1381
Fax
(660) 827-3001
NPI assigned
Aug 27, 2007
Last updated
Aug 27, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 093560 MO Primary

Addresses

Primary practice location

3131 Brianna Blvd
Sedalia, MO 65301-2285

Mailing address

3131 Brianna Blvd
Sedalia, MO 65301-2285
Phone (660) 826-1381

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20081217000128 MO Practitioner - Nurse Practitioner 4880756352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bothwell Regional Health CenterGroup PAC ID 6103714126, 109 clinicians

Practice addresses (Care Compare)

700 S Hancock Ave
Bothwell Eldenburg Family Practice
Sedalia, MO 65301-4638
Phone (660) 827-7998

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bothwell Regional Health Center Current Accepting new patients
Bothwell Regional Health Center CurrentSince Jan 1, 2024 Accepting new patients
Bothwell Regional Health Center CurrentSince Jan 1, 2024 Accepting new patients

Locations

3131 Brianna Blvd
Sedalia, MO 65301
Phone (660) 460-3038

601 E 14th St
Sedalia, MO 65301
Phone (660) 826-8833

700 S Hancock Ave
Sedalia, MO 65301
Phone (660) 827-4664

1765 Commercial St
Warsaw, MO 65355
Phone (660) 438-6800

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1188172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188172800000",
    "number": "1316130032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 BRIANNA BLVD",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012285",
            "telephone_number": "660-826-1381",
            "fax_number": "660-827-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 BRIANNA BLVD",
            "city": "SEDALIA",
            "state": "MO",
            "postal_code": "653012285",
            "telephone_number": "660-826-1381",
            "fax_number": "660-827-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYKE",
        "first_name": "PEGGY",
        "middle_name": "A",
        "credential": "MSN, APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "093560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sedalia, MO

Sources for this page

Verify at the official NPI Registry.