Peter S. Vandemark, MD, PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301038966 Issued in MI

Legal business name

PETER S. VANDEMARK, MD, PC

Practice address

705 Oak Street
Suite 11
Big Rapids, MI 49307

Phone

(231) 796-4406

Fax

(231) 796-2770

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Peter S Vandemark, M.D.

Title

President/Owner

Phone

(231) 796-4406

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Big Rapids Internal Medicine Doing business as

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1376643155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 OAK STREET",
            "address_2": "SUITE 11",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "49307",
            "telephone_number": "231-796-4406",
            "fax_number": "231-796-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 OAK STREET",
            "address_2": "SUITE 11",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "49307",
            "telephone_number": "231-796-4406",
            "fax_number": "231-796-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER S. VANDEMARK, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "VANDEMARK",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "231-796-4406",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301038966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3377875",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0540004",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Big Rapids Internal Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Matthew Parrish
• Dylan Mikel Pavka, AT, ATC
• Pediatric Associates of Big Rapids, P.C.
• Rachel Skye Perkins, L.M.S.W.
• Erick K Perroud, DDS
• Peter Zadvinskis MD PC
• Caleb John Peter
• Nancy Peterson Klein, OD
• Stephen Charles Peterson, DO
• Christopher Lee Petoskey, CRNP

• Internal Medicine Physician in Big Rapids, MI
• Providers in Big Rapids, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.