KEVIN VARDON (NPI# 1508870718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508870718 |
| Entity Type | Individual |
| Full Name | KEVIN VARDON |
| Credential | PA-C |
| Practice Address |
15100 Whittaker Way Grand Haven MI 49417-8696 |
| Mailing Address |
100 Michigan St Ne # Mc845 Grand Rapids MI 49503-2560 |
| Practice Telephone | 6169356260 |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2018-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 5601004839 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | MEDICARE RAILROAD | PO1223803 | 01 |
| MI | MEDICARE GROUP PTAN | OD14869 | 01 |
| Street Address |
15100 WHITTAKER WAY |
| City | GRAND HAVEN |
| State | MI |
| Zip Code | 49417-8696 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952303117 | Thomas F. Alguire | Internal Medicine | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2005-06-01 |
| 1417581265 | River A David | Physician Assistant | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2020-03-02 |
| 1003458423 | Kelly Lynn Ouellette | Occupational Therapist | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2019-10-17 |
| 1114570595 | Ciera Marie Grevengoed | Physical Therapist | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2019-07-24 |
| 1720547250 | Karoline Luise Arsenault | Physician Assistant | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2019-03-14 |
| 1922566462 | Cara Ashni Schipper | Occupational Therapist | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2019-03-04 |
| 1942778915 | Rachael Joymarie Scoby | Speech-Language Pathologist | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2018-11-08 |
| 1447727326 | Laura Lynn Rohrs | Nurse Practitioner | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2018-10-29 |
| 1194209247 | Melissa Lynn Lewandowski | Physical Therapist | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2018-09-24 |
| 1659853182 | Brandi Sue Brower | Social Worker | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2018-08-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295393478 | Compassionate Christian Therapy, LLC | Social Worker | 16989 Robbins Rd, Grand Haven, MI 49417 | 2019-06-03 |
| 1275098501 | Christi Rene Fortenbacher | Massage Therapist | 318 S. Beacon Blvd, Grand Haven, MI 49417 | 2019-01-31 |
| 1518440650 | Jessica Hankins | Physical Therapy Assistant | 15773 Charles Ct, Grand Haven, MI 49417 | 2018-09-14 |
| 1558857466 | Christina Steege | Physical Therapist | 514 Friant St, Grand Haven, MI 49417 | 2018-07-03 |
| 1851822548 | Forefront Dermatology, S.c. | Dermatology | 1600 S Beacon Blvd, Suite 160, Grand Haven, MI 49417 | 2017-03-23 |
| 1982057907 | Jeremyn Duane Wiersma | Counselor | 1703 S. Despelder St., Grand Haven, MI 49417 | 2016-07-14 |
| 1760855225 | Lisa Costello | Dental Hygienist | 326 N. Ferry St, Grand Haven, MI 49417 | 2015-11-05 |
| 1508116088 | Great Lakes Chiropractic Health | Chiropractor | 15 S. Seventh St., Grand Haven, MI 49417 | 2012-09-12 |
| 1508120122 | Jonathan Stewart Rouwhorst | Family Medicine | 15161 Willowwood Ct, Grand Haven, MI 49417 | 2012-06-28 |
| 1104108836 | Employee Assistance Center Fulton | Psychologist | 321 Fulton, Grand Haven, MI 49417 | 2011-09-20 |
| Find all providers in zip 49417 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629683966 | Kasey Felten | Physician Assistant | 17168 Timber View Dr, Grand Haven, MI 49417-6934 | 2020-09-14 |
| 1851594501 | Theresa Jean Pebbles | Physician Assistant | 1310 Wisconsin Street, Suite 301, Grand Haven, MI 49417 | 2007-06-08 |
| 1083688741 | Katie Elizabeth Zarnosky | Physician Assistant | 1310 Wisconsin St Ste 301, Grand Haven, MI 49417-2472 | 2006-02-17 |
| 1417581265 | River A David | Physician Assistant | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2020-03-02 |
| 1598304701 | Privamd Physicians Pllc | Physician Assistant | 16986 Robbins Rd Ste 180, Grand Haven, MI 49417-2795 | 2020-01-06 |
| 1720547250 | Karoline Luise Arsenault | Physician Assistant | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2019-03-14 |
| 1770070310 | Mary Tran | Physician Assistant | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2018-04-19 |
| 1780139709 | Jordan Gerard Maccoux | Physician Assistant | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2016-08-19 |
| 1376809434 | Hannah H O'brien | Physician Assistant | 15100 Whittaker Way, Grand Haven, MI 49417-8696 | 2012-04-03 |
| 1023208105 | Jason Allan May | Physician Assistant | 1309 Sheldon Rd, Grand Haven, MI 49417-2404 | 2007-07-26 |
| Find all providers in GRAND HAVEN | ||||
| City | GRAND HAVEN |
| Zip Code | 49417 |
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| 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.