Johnny Vandiver, PA
NPI 1629059126 · Physician Assistant · Joint Base Lewis Mchord, WA
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Johnny Vandiver, PA is a Physician Assistant provider in Joint Base Lewis Mchord, WA (NPI 1629059126).
Provider details
- NPI number
- 1629059126
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2005-11-10
- Last updated
- 2012-11-07
Frequently asked questions
- What is Johnny Vandiver's NPI number?
- Johnny Vandiver's National Provider Identifier (NPI) is 1629059126, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Johnny Vandiver's specialty?
- Johnny Vandiver is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Johnny Vandiver located?
- Johnny Vandiver's practice location on file with NPPES is 12233 24th Street, Joint Base Lewis Mchord, WA 98433.
- What is Johnny Vandiver's phone number?
- The practice phone number listed in the NPPES registry for Johnny Vandiver is (253) 477-5734.
- Does Johnny Vandiver accept Medicare?
- Johnny Vandiver is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Johnny Vandiver's NPI active?
- Yes — Johnny Vandiver's NPI (1629059126) is active in the NPPES registry as of the last update on 2012-11-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.