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ORMOND INTERNAL MEDICINE LLC
NPI 1023209095
Internal Medicine in Ormond Bch, FL

Active since August 06, 2007CLIA 10D0967903 · Waiver
279 S. YONGE ST., ORMOND BCH, FL 32174(386) 673-2133(386) 673-2743 Get Directions Write a Review

NPPES record last updated: July 25, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Ormond Internal Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ORMOND INTERNAL MEDICINE LLC (NPI 1023209095) is a healthcare organization registered as an internal medicine in Ormond Bch, Florida and active in the NPI registry since August 2007. The organization holds a CLIA Waiver certificate valid through August 9, 2028 and lists Patricia Gail Vandiepen, Owner, as its authorized official.

NPPES Registry Identity

NPI1023209095
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameORMOND INTERNAL MEDICINE LLC
Location Address279 S. YONGE ST.Ormond Bch, FL 32174
Mailing Address279 S. Yonge St.Ormond Bch, FL 32174 · (386) 673-2133 · Fax (386) 673-2743
Phone(386) 673-2133
Fax(386) 673-2743
Organization SubpartNo
Authorized OfficialPatricia Gail VandiepenOwner · (386) 673-2133
Enumeration DateAugust 6, 2007
Last NPPES UpdateJuly 25, 2024
NPPES CertifiedJuly 25, 2024
✔ NPI 1023209095 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in FL · OS7544
Definition
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.
279 S. YONGE ST., Ormond Bch, FL 32174
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ormond Internal Medicine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Ormond Internal Medicine LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Jody King, ARNP, FNP-C
Nurse Practitioner
NPI 1750097267
279 S YONGE ST
Ormond Beach, FL 32174
(386) 673-2133
✔ PECOS✔ Accepts MedicareSame address
Patricia Vandiepen, DO
Internal Medicine
NPI 1568435659
279 S YONGE ST
Ormond Beach, FL 32174
(386) 673-2133
✔ PECOS✔ Accepts Medicare1.1 mi
Heather Rebro, APRN
Nurse Practitioner
NPI 1558061168
420 S NOVA RD STE 5
Ormond Beach, FL 32174
(386) 506-0111
✔ PECOS✔ Accepts Medicare1.7 mi
Ronnie Hoelker, FNP
Nurse Practitioner
NPI 1811319908
305 MEMORIAL MEDICAL PKWY STE 201
Daytona Beach, FL 32117
(386) 586-1840
✔ PECOS✔ Accepts Medicare4.1 mi
Andrea Thompson, NP
Nurse Practitioner
NPI 1346717881
600 N PEACH ST
Bunnell, FL 32110
(386) 237-4032
✔ PECOS✔ Accepts Medicare17 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 10D0967903

Ormond Internal Medicine LLC · Ormond Beach, FL
Active · expires Aug 9, 2028
CLIA Number10D0967903
Laboratory TypePhysician Office
Certificate Effective DateAugust 10, 2026
Certificate Expiration DateAugust 9, 2028
Laboratory DirectorGail Van Diepen
Laboratory Phone(386) 673-2133
Laboratory LocationOrmond Internal Medicine LLC279 S Yonge St, Ormond Beach, FL 32174
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ormond Internal Medicine LLC's NPI number?

The NPI number for Ormond Internal Medicine LLC is 1023209095. It was assigned to this organization in the NPPES registry on August 6, 2007.

Where is Ormond Internal Medicine LLC located?

Ormond Internal Medicine LLC is located at 279 S. Yonge St., Ormond Bch, FL 32174. The listed phone number is (386) 673-2133.

What is Ormond Internal Medicine LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Ormond Internal Medicine LLC enrolled in Medicare?

Yes. Ormond Internal Medicine LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Ormond Internal Medicine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 2 Medicare specialties reassign their Medicare billing to Ormond Internal Medicine LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (4) and Internal Medicine (1). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Ormond Internal Medicine LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 10D0967903) is associated with this NPI, valid through August 9, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ormond Internal Medicine LLC was last updated on July 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.