Active NPI
John Millard Vandeventer, PHARM. D.
- Pharmacist
- Bristol, VA
National Provider Identifier
1598849515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 0202006306
- Practice address
- 1883 Euclid Ave
Bristol, VA 24201-3605 - Phone
- (276) 466-3600
- Fax
- (276) 466-3578
- NPI assigned
- Oct 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 0202006306 | VA | Primary |
Addresses
Primary practice location
1883 Euclid Ave
Bristol, VA 24201-3605
Mailing address
16053 Rocky Top RDG
Bristol, VA 24202-4981
Phone (276) 466-3600
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202006306 | VA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598849515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16053 ROCKY TOP RDG",
"city": "BRISTOL",
"state": "VA",
"postal_code": "242024981",
"telephone_number": "276-466-3600",
"fax_number": "276-466-3578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1883 EUCLID AVE",
"city": "BRISTOL",
"state": "VA",
"postal_code": "242013605",
"telephone_number": "276-466-3600",
"fax_number": "276-466-3578"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDEVENTER",
"first_name": "JOHN",
"middle_name": "MILLARD",
"name_prefix": "Dr.",
"credential": "PHARM. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "VA",
"license": "0202006306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bristol, VA
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.