MR. KENT WAYNE VANDEVENDER PA-C NPI 1407886203

NPI Information

NPI: 1407886203
Provider Name: MR. KENT WAYNE VANDEVENDER, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
103 VALLEY CENTER DR
STAUNTON, VA
ZIP 24401
Phone: (540) 332-8220
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MR. Kent Wayne Vandevender, PA-C is a medical physician assistant in Staunton, VA. MR. Kent Wayne Vandevender, PA-C NPI is 1407886203. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

103 VALLEY CENTER DR
STAUNTON, VA
ZIP 24401-080
Phone: (540) 332-8220
Fax: (540) 332-8385

The enumeration date for this NPI number is 7/4/2006 and was last updated on 8/3/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	621	WEST VIRGINIA	No
2	363AM0700X	Physician Assistant	Medical	0110002674	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	WV2885A	MEDICARE PIN	WEST VIRGINIA
2	WV2885C551	MEDICARE PIN	WEST VIRGINIA
3	3810026229	MEDICAID	WEST VIRGINIA
4	P12025	MEDICARE UPIN	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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