Individual provider Active NPI

Grace Vandyk

  • Primary Care Nurse Practitioner
  • Wellington, FL
National Provider Identifier
1730301672
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
1704182 Issued in FL
Practice address
3347 State Road 7
Ste 200
Wellington, FL 33449-8095
Phone
(561) 795-9087
Fax
(561) 795-4036
NPI assigned
May 2, 2007
Last updated
May 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 1704182 FL Primary

Addresses

Primary practice location

3347 State Road 7
Ste 200
Wellington, FL 33449-8095

Mailing address

PO Box 1602
Loxahatchee, FL 33470
Phone (561) 795-9087

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

State licenses

LicenseStateTypeSpecialty
1704182FLMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Community Health Services Past Accepting new patients
Glades Primary Care LLC Past Accepting new patients
Vitalmd Group Holding LLC Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1730301672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1602",
            "city": "LOXAHATCHEE",
            "state": "FL",
            "postal_code": "33470",
            "telephone_number": "561-795-9087",
            "fax_number": "561-795-4036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3347 STATE ROAD 7",
            "address_2": "STE 200",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334498095",
            "telephone_number": "561-795-9087",
            "fax_number": "561-795-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDYK",
        "first_name": "GRACE",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "FL",
            "license": "1704182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; 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.