Douglas M Vandrie, M.D.

Primary specialty

Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X

License

4301037779 Issued in MI

Practice address

555 Midtowne Street NE
Suite 450
Grand Rapids, MI 49503-5732

Phone

(616) 588-1800

Fax

(616) 588-1850

NPI assigned

Jul 27, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1376557389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE STREET NE",
            "address_2": "SUITE 400",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035731",
            "telephone_number": "616-588-1800",
            "fax_number": "616-588-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE STREET NE",
            "address_2": "SUITE 450",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035732",
            "telephone_number": "616-588-1800",
            "fax_number": "616-588-1850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDRIE",
        "first_name": "DOUGLAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "MI",
            "license": "4301037779",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1332800",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Luke Vandezande, MD
• Angela Marie Vandine, PA-C
• Kevin Vandokkumburg, PA-C
• Allison Marie Vandoorne, LLMSW
• Kimberly J Vandorp, PHARM-D
• Sara Vandrie, ETS, GCDF
• Courtney Vandriel, RN, IBCLC
• Lauren Vandrunen, LMSW
• Carly Vanduinen
• Joni Vanduinen, DO

• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.