John H. Vandergrift, M.D.

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

01036755 Issued in IN

Practice address

600 East Blvd
Elkhart, IN 46514-2483

Phone

(574) 523-3161

Fax

(574) 273-1137

NPI assigned

Mar 8, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Elite Emergency Physicians Inc

  • Emergency Medicine Physician
  • Elkhart, IN
  • NPI 1932155371
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213228800000",
    "number": "1437127388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4755 AMERITECH DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST BLVD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142483",
            "telephone_number": "574-523-3161",
            "fax_number": "574-273-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERGRIFT",
        "first_name": "JOHN",
        "middle_name": "H.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2008-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IN",
            "license": "01036755",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8460412",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100259060",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Van de Wielle
• Stacey Van Eck, M.ED., ED.S.
• Debra Vance, LMHC
• Karli Vance
• Amanda Vandergriff
• Michael Lee Vanderveer, BSPHARM
• Lisa A Vanhouten, MSW, LCSW
• Mena K Vanhphoumy, COTA
• Roger J Vanorsdoll, M.D.
• David E Vanryn, MD

• Emergency Medical Services (Emergency Medicine) Physician in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; 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.