David K Vandekieft, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004449 Issued in MI

Practice address

419 S Coral St
Kalkaska, MI 49646-2503

Phone

(231) 258-7500

Fax

(231) 258-7527

NPI assigned

May 15, 2007

Last updated

Nov 19, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18841/brand/1/csg/1/fhir/r4

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.

• Campbell County Hospital District

  dba Campbell County Medical Group - Internal Medicine Clinic

  • Internal Medicine Physician
  • Gillette, WY
  • NPI 1710098868
  Medicare reassignment
• Community Hospital

  • Critical Access Hospital
  • Torrington, WY
  • NPI 1669410643
  Medicare reassignment
• Kalkaska Memorial Health Center

  • Skilled Nursing Facility
  • Kalkaska, MI
  • NPI 1164386652
  NPD
• Kalkaska Memorial Health Center

  • Rural Health Clinic/Center
  • Mancelona, MI
  • NPI 1275307670
  NPD
• Munson Medical Center

  dba Munson Rheumatology Consultants

  • Rheumatology Physician
  • Traverse City, MI
  • NPI 1912225400
  NPD
• Paul Oliver Memorial Hospital

  dba Frankfort Medical Group a Service of Paul Oliver Memorial Hospital

  • Rural Health Clinic/Center
  • Frankfort, MI
  • NPI 1306471305
  NPD
• Paul Oliver Memorial Hospital

  • Skilled Nursing Facility
  • Frankfort, MI
  • NPI 1649133943
  NPD
• Campbell County Hospital District

  dba Behavioral Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Gillette, WY
  • NPI 1881730141
  NPD
• Campbell County Hospital District

  dba Campbell County Health

  • Community/Retail Pharmacy
  • Gillette, WY
  • NPI 1992874218
  NPD
• Campbell County Hospital District,

  dba Campbell County Medical Group - Post Discharge Clinic

  • General Practice Physician
  • Gillette, WY
  • NPI 1922784891
  NPD
• Community Hospital

  • Multi-Specialty Clinic/Center
  • Torrington, WY
  • NPI 1164950036
  NPD
• Community Hospital

  • Rural Health Clinic/Center
  • Torrington, WY
  • NPI 1174059786
  NPD

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1457567851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 S CORAL ST",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496462503",
            "telephone_number": "231-258-7500",
            "fax_number": "231-258-7527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 S CORAL ST",
            "city": "KALKASKA",
            "state": "MI",
            "postal_code": "496462503",
            "telephone_number": "231-258-7500",
            "fax_number": "231-258-7527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Sixth St",
            "address_purpose": "LOCATION",
            "city": "Traverse City",
            "state": "MI",
            "postal_code": "496842345",
            "country_code": "US",
            "telephone_number": "231-935-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDEKIEFT",
        "first_name": "DAVID",
        "middle_name": "K",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "20768",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WY",
            "license": "183",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457567851",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457567851",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M011002915",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aaron David Swoverland, DPT
• Townline Family PC (Kalkaska Family Vision Care)
• Traverse City Eye Consultants P C
• Timothy John Troupe, OD
• Sharon Marie Van Tuyl, P.A.-C
• Kara Emery Vanderwoude
• Village Chiropractic Wellness Center, PLC
• Erin Bridget Vorgias, MSW INTERN
• Christina Lynn Weasel Brege, PA-C
• Erin Leigh Welsh

• Physician Assistant in Kalkaska, MI
• Providers in Kalkaska, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.