NPIMap

Individual provider Active NPI

Gregg K Vandekieft, M.D.

  • Family Medicine Physician
  • Olympia, WA
National Provider Identifier
1922009885
Registry record updated Apr 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD00027326 Issued in WA
Practice address
525 Lilly Rd NE
Olympia, WA 98506-5101
Phone
(360) 493-7230
Fax
(360) 493-4180
NPI assigned
Aug 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD00027326 WA Primary

Addresses

Primary practice location

525 Lilly Rd NE
Olympia, WA 98506-5101

Mailing address

PO Box 3360
Portland, OR 97208-3360
Phone (360) 486-6508

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gvandekieft99746@wm.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090518000009 WA Practitioner - Hospice/Palliative CarePractitioner - Family Practice 0749338333 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 7719873496, 14 clinicians
Providence Health and Services WashingtonGroup PAC ID 9234048323, 11 clinicians

Practice addresses (Care Compare)

413 Lilly Rd NE
Olympia, WA 98506-5133
Phone (360) 491-9480

914 S Scheuber Rd
Centralia, WA 98531-9027
Phone (360) 736-2803

Hospital & facility affiliations

  • Providence at Home With Compassus, Puget Sound South Hospice, Lacey, WA, CCN 501511
  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD00027326WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington Family Medicine CurrentSince Dec 23, 2017 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Washington Family Medicine CurrentSince Jan 30, 2017 Accepting new patients
Providence Health & Services Washington CurrentSince Dec 23, 2017 Accepting new patients

Locations

914 S Scheuber Rd
Centralia, WA 98531
Phone (360) 330-8516

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

410 Providence Ln NE
Bldg 2
Olympia, WA 98506
Phone (360) 493-4500

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Providence at Home With Compassus, Puget Sound SouthLacey, WA, CCN 501511 Hospice Contracted Managing Employee Feb 27, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619136000000",
    "number": "1922009885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360",
            "telephone_number": "360-486-6508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-493-7230",
            "fax_number": "360-493-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEKIEFT",
        "first_name": "GREGG",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2021-04-23",
        "certification_date": "2021-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00027326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gvandekieft99746@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "413 Lilly Rd NE",
            "city": "Olympia",
            "state": "WA",
            "country_code": "US",
            "postal_code": "985065133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.