Active NPI
Angela Michelle Vandyke, RN
- Family Medicine Physician
- Columbia, SC
National Provider Identifier
1396368932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 77820
- Practice address
- 7037 Saint Andrews Rd
Columbia, SC 29212-1177 - Phone
- (803) 732-0963
- Fax
- (803) 732-1406
- NPI assigned
- May 18, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 77820 | SC | Primary |
Addresses
Primary practice location
7037 Saint Andrews Rd
Columbia, SC 29212-1177
Mailing address
109 Farmhouse CT
Lexington, SC 29072-2793
Phone (803) 622-7652
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77820 | SC | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589760000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589760000000",
"number": "1396368932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 FARMHOUSE CT",
"city": "LEXINGTON",
"state": "SC",
"postal_code": "290722793",
"telephone_number": "803-622-7652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7037 SAINT ANDREWS RD",
"city": "COLUMBIA",
"state": "SC",
"postal_code": "292121177",
"telephone_number": "803-732-0963",
"fax_number": "803-732-1406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDYKE",
"first_name": "ANGELA",
"middle_name": "MICHELLE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-18",
"last_updated": "2020-05-18",
"certification_date": "2020-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "SC",
"license": "77820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbia, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.