Randy Paul Vawdrey, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

NP-659 Issued in ID

Practice address

495 Yellowstone Ave
Pocatello, ID 83201-4531

Phone

(208) 478-7422

NPI assigned

Jul 12, 2006

Last updated

Jul 9, 2007By 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

Specialty

Nurse Practitioner

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

MVH Pic LLCGroup PAC ID 6709156904, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mountain View Hospital Hospital, Idaho Falls, ID, CCN 130065
• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• MVH Pic LLC

  • Family Medicine Physician
  • Pocatello, ID
  • NPI 1972035772
  Medicare reassignment Care Compare group
• MVH PMHS LLC

  • Mental Health Counselor
  • Pocatello, ID
  • NPI 1649704248
  Medicare reassignment
• Advanced Healthcare Solutions LLC

  dba Physicians Immediate Care Center

  • Urgent Care Clinic/Center
  • Pocatello, ID
  • NPI 1700803632
  Authorized official Same address or phone
• G Adrian Dean MD Inc

  • Psychiatry Physician
  • Twin Falls, ID
  • NPI 1386737989
  NPD (past)
• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mountain View Hospital LLC

  • General Acute Care Hospital
  • Idaho Falls, ID
  • NPI 1669462362
  Care Compare affiliation
• Pocatello Hospital LLC

  dba Portneuf Rehabilitation Center

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  dba Portneuf Medical Center

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1376568493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 DELMAR PLACE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "83201",
            "telephone_number": "208-238-8145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 YELLOWSTONE AVE",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014531",
            "telephone_number": "208-478-7422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAWDREY",
        "first_name": "RANDY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "ID",
            "license": "NP-659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julio Cesar Vasquez, M.D.
• Peyton Vasquez
• Ammon Joel Vaterlaus, OD
• Bryson Kay Vaughan, LPC
• Joni D Vaughn Powell, RPT
• Cory Veigel, DMD
• Vera Whole Health Wa PC (Amy's Family Health Center)
• Patrick T Vereecken
• Veteran Home Care LLC
• Amanda Lynn Vias

• Primary Care Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Primary Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.