Individual provider Active NPI

Robert F Vandiver, M.D.

  • Psychiatry Physician
  • Albany, OR
National Provider Identifier
1457444390
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD14063 Issued in OR
Practice address
445 3Rd Ave SW
Albany, OR 97321-2272
Phone
(541) 967-3866
Fax
(541) 928-3020
NPI assigned
Oct 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD14063 OR Primary

Addresses

Primary practice location

445 3Rd Ave SW
Albany, OR 97321-2272

Mailing address

PO Box 100
Albany, OR 97321-0031
Phone (541) 967-3866

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD14063ORMDPsychiatry Physician
14063ORMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457444390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973210031",
            "telephone_number": "541-967-3866",
            "fax_number": "541-928-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 3RD AVE SW",
            "city": "ALBANY",
            "state": "OR",
            "postal_code": "973212272",
            "telephone_number": "541-967-3866",
            "fax_number": "541-928-3020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDIVER",
        "first_name": "ROBERT",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OR",
            "license": "MD14063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.