Johnny Ray Vandiver, PA is a medicare enrolled "Physician Assistant" in Joint Base Lewis Mchord, Washington. He graduated from nursing school in 1998 and has 28 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Tanana Chiefs Conference and his current practice location is
12233 24th Street, Joint Base Lewis Mchord, Washington. You can reach out to his office (for appointments etc.) via phone at
(253) 477-5734.
Johnny Ray Vandiver is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1629059126.
Provider's Profile
| Full Name | Johnny Ray Vandiver |
|---|
| Gender | Male |
|---|
| Speciality | Physician Assistant |
|---|
| Experience | 28 Years |
|---|
| Location | 12233 24th Street, Joint Base Lewis Mchord, Washington |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Johnny Ray Vandiver graduated from nursing school in 1998
NPI Data:
- NPI Number: 1629059126
- Provider Enumeration Date: 11/10/2005
- Last Update Date: 11/07/2012
Medicare PECOS Information:
- PECOS PAC ID: 2264755792
- Enrollment ID: I20150108000380
Medical Identifiers
Medical identifiers for Johnny Ray Vandiver such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629059126 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Tanana Chiefs Conference | 9537050109 | 153 |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Johnny Ray Vandiver is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Johnny Ray Vandiver, PA
Po Box 33154,
Juneau, AK 99803-3154
Ph: (907) 687-8224 | Johnny Ray Vandiver, PA
12233 24th Street,
Joint Base Lewis Mchord, WA 98433
Ph: (253) 477-5734 |
Reviews and Comments