Wayne E Vanderkolk, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

057820 Issued in MI

Practice address

1045 Gezon Pkwy SW
Wyoming, MI 49509-9542

Phone

(616) 456-5311

Fax

(616) 456-7955

NPI assigned

Jun 22, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151
  Medicare reassignment NPD
• West Michigan Surgical Specialists PLC

  • Surgery Physician
  • Wyoming, MI
  • NPI 1679508659
  Medicare reassignment NPD
• Advantage Health Saint Mary'S Medical Group

  • Orthopaedic Surgery Physician
  • Byron Center, MI
  • NPI 1003515008
  NPD
• Advantage Health Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1952340911
  NPD
• Academic Surgical Associates, PLLC

  • Surgical Oncology Physician
  • Grand Rapids, MI
  • NPI 1114139045
  NPD (past)
• Saint Mary'S Health Services

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1639111057
  NPD (past)
• Spectrum Health Primary Care Partners

  • Colon & Rectal Surgery Physician
  • Grand Rapids, MI
  • NPI 1194037127
  NPD (past)

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

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1821094129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 GEZON PKWY SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495099542",
            "telephone_number": "616-456-5311",
            "fax_number": "616-456-7955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 GEZON PKWY SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495099542",
            "telephone_number": "616-456-5311",
            "fax_number": "616-456-7955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERKOLK",
        "first_name": "WAYNE",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "057820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3360653",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Marie Vander Laan, LLMSW
• Jennifer Marie Vander Wilp, MA, LLPC
• Kelsee Amber Vanderbaan, NP
• Lindsay M Vandergeld
• Carol Jane Vandergraaf, RN
• Katelynn Ann Vanderkooi, DC
• Burton F Vanderlaan, MD
• Sarah Vanderlaan, RDH
• Megan L Vandermaas, PA-C
• Todd R Vandermeer, D.D.S.

• Surgery Physician in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Surgery Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.