DR. BRYAN VANDYKE (NPI# 1285990374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285990374 |
| Entity Type | Individual |
| Full Name | DR. BRYAN VANDYKE |
| Credential | D.O. |
| Practice Address |
2321 Coronado St Idaho Falls ID 83404-7407 |
| Mailing Address |
3611 Boulder Creek Ln Idaho Falls ID 83406-5114 |
| Practice Telephone | 2082271100 |
| Mailing Telephone | 9194751161 |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2019-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
O-1166 | ID | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
2321 CORONADO ST |
| City | IDAHO FALLS |
| State | ID |
| Zip Code | 83404-7407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730297706 | Philip R Mccowin | Orthopaedic Surgery | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2006-08-29 |
| 1801174370 | Nathan S Rencher | Orthopaedic Surgery | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2011-08-01 |
| 1306090030 | Emergency Orthopedic Services of Idaho Pllc | Orthopaedic Surgery | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2008-11-07 |
| 1962545681 | Summit Orthopaedics Management and Consulting, LLC | Durable Medical Equipment & Medical Supplies | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2007-02-14 |
| 1760531073 | Frank R Angelo | Technician | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2007-01-09 |
| 1851485031 | Summit Orthopaedics Management and Consulting, LLC | Orthopaedic Surgery | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2006-10-03 |
| 1912015074 | Gregory G West | Orthopaedic Surgery | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2006-08-29 |
| 1679681738 | Stan R Griffiths | Orthopaedic Surgery | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2006-08-29 |
| 1417065483 | Lance B Turpin | Physician Assistant | 2321 Coronado St, Idaho Falls, ID 83404-7407 | 2006-08-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437750809 | Joshua M Murphy | Dentist | 1580 Elk Creek Dr., Idaho Falls, ID 83404 | 2020-11-03 |
| 1427618958 | Eastern Idaho Endodontics | Dentist | 3335 S. Holmes Ave, Idaho Falls, ID 83404 | 2019-06-17 |
| 1942863600 | Muhammad Arslan Khan | Student in an Organized Health Care Education/Training Program | 2860 Channing Way Suite 214, Idaho Falls, ID 83404 | 2019-04-18 |
| 1942771043 | Physician's Choice Cardiology, Pllc | Internal Medicine | 3302 Valencia, Suite 201, Idaho Falls, ID 83404 | 2018-12-16 |
| 1609358761 | Cardiac Cath Lab of Idaho Falls | Internal Medicine | 3311 Valencia Drive, Idaho Falls, ID 83404 | 2018-09-05 |
| 1083196380 | Hannah Golden | Occupational Therapist | 1460 Elk Creek, Idaho Falls, ID 83404 | 2018-09-04 |
| 1316423049 | Lindsay Sessions | Speech-Language Pathologist | 2210 Niagara St, Idaho Falls, ID 83404 | 2018-07-16 |
| 1720574023 | Bmh, Inc. | Anesthesiology | 3302 Valencia Dr., Suite 201, Idaho Falls, ID 83404 | 2018-07-10 |
| 1093237935 | Jason Earl Bailey | Contractor | 3100 S Woodruff Ave., Idaho Falls, ID 83404 | 2017-07-12 |
| 1235682121 | Mountain Falls Quick Care | Clinic/Center | 1995 E 17th St #1, Idaho Falls, ID 83404 | 2016-07-27 |
| Find all providers in zip 83404 | ||||
| Taxonomy Code | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598107815 | Travis Jay Kemp Md Inc | Orthopaedic Surgery | 7979 W Rifleman St, Boise, ID 83704-9066 | 2013-07-28 |
| 1669607172 | Travis Jay Kemp | Orthopaedic Surgery | 7979 W Rifleman St, Boise, ID 83704-9066 | 2009-05-28 |
| 1508922303 | Michael J Coughlin, Md, Pa | Orthopaedic Surgery | 901 N Curtis Rd, Suite 503, Boise, ID 83706-1338 | 2006-12-28 |
| 1992716872 | Steven E Roser | Orthopaedic Surgery | 600 N Robbins Rd, Ste 100, Boise, ID 83702-4566 | 2006-08-10 |
| 1255364030 | Weiser Valley Hospital District | Orthopaedic Surgery | 645 E. 5th St., Weiser, ID 83672 | 2006-07-07 |
| 1760477368 | Timothy Joseph Flock | Orthopaedic Surgery | 320 Warner Dr, Lewiston, ID 83501 | 2005-09-20 |
| City | IDAHO FALLS |
| Zip Code | 83404 |
Please comment or provide details below to improve the information on DR. BRYAN VANDYKE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.