Vandyke Chiropractic PC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

0104001184 Issued in VA

Legal business name

VANDYKE CHIROPRACTIC PC

Practice address

1779 Lovers Gap Road
Vansant, VA 24656

Phone

(276) 597-8387

Fax

(276) 597-2154

NPI assigned

Apr 27, 2007

Last updated

Nov 28, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bradley Dean Vandyke, DCNPI 1013981356

Title

Clinic Director

Phone

(276) 597-8387

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley Dean Vandyke, D.C.

  • Sports Physician Chiropractor
  • Vansant, VA
  • NPI 1013981356
  Medicare reassignment NPD Authorized official
• Melissa Kay Horne, CMT

  • Massage Therapist
  • Vansant, VA
  • NPI 1558489484
  NPD (past)

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

{
    "created_epoch": "1177632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322438400000",
    "number": "1649490855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 855",
            "city": "VANSANT",
            "state": "VA",
            "postal_code": "246560855",
            "telephone_number": "276-597-8387",
            "fax_number": "276-597-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1779 LOVERS GAP ROAD",
            "city": "VANSANT",
            "state": "VA",
            "postal_code": "24656",
            "telephone_number": "276-597-8387",
            "fax_number": "276-597-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANDYKE CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-27",
        "last_updated": "2011-11-28",
        "status": "A",
        "authorized_official_last_name": "VANDYKE",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "276-597-8387",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104001184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7600037000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dia Rife, P.T.
• Traci Leeann Rowlett, FNP-C
• Jane Adele Seymour, COTA/L
• Barbara L Shinall, FNP
• St. Charles Health Council Inc (Thompson Family Health Center)
• Bradley Dean Vandyke, D.C.
• Sandra Jean Vandyke, FNP
• Viers Hunt Broyles, & Brown, Inc. (Family Drug)
• Anita Renee Woolford, MSN, NP-C

• Sports Physician Chiropractor in Vansant, VA
• Providers in Vansant, VA by specialty
• Sports Physician Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.