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Deactivated NPI 1801079306 Deactivated / Inactive NPI Female Practitioner

Dr. Kelly S Vandyke , MD

Internal Medicine • Fries, VA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Kelly Vandyke has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 07, 2007
NPI Deactivation Date December 12, 2024
Total Practice Duration ~17 Years of Practice (2007 – 2024)

Professional Overview & Biography Verified Profile Summary

Dr. Kelly Vandyke, MD was a registered Internal Medicine practicing in Fries, VA. Throughout an active medical career spanning 17 years, Dr. Vandyke provided care at the practice location at 109 CARROLL DRIVE until profile deactivation on 2024-12-12.

Historical Medicare Part B clinical services included urinalysis, manual test, routine electrocardiogram (ecg) using at least 12 leads with tracing, insertion of needle into vein for collection of blood sample. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

109 Carroll Drive

Fries, VA 24330

Telephone 2767443660
Fax 2767443843
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Fries, VA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 26.1 Yrs
Regional Practice Density
1 Specialists

Practicing in Fries, VA (3758 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
43.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2019)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
81002 Urinalysis, manual test
55 39 $6.00 $3.41

Medical Specialties & State Licenses

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License VA 0101048616

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Joy Creed , FNP-C

Nurse Practitioner

NPI 1679592554

Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated December 12, 2024

Record deactivated on December 12, 2024

NPI Profile Active January 09, 2012

NPI status registered as active in NPPES database

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Updated Practice Location January 09, 2012

Registered at 109 CARROLL DRIVE, FRIES, VA 24330 (Tel: 2767443660)

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Updated Business Mailing Address January 09, 2012

Registered at 109 CARROLL DRIVE, FRIES, VA 24330 (Tel: 2767443660)

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Provider Name / Credentials Updated January 09, 2012

Recorded as KELLY VANDYKE, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 09, 2012

Internal Medicine (License #0101048616 in VA)

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Initial NPI Registration & Enumeration December 07, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1801079306
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 07, 2007
Last Update: January 09, 2012
Deactivation Date: December 12, 2024

Mailing Address

109 Carroll Drive

Fries, VA 24330

Phone: 2767443660

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.