LUCAS R VANDERMYDE DO
NPI 1164083523
Family Medicine in Nellis Afb, NV

Q: What is Lucas Vandermyde's NPI number?

The NPI number for Lucas Vandermyde is 1164083523. It was assigned to this individual provider in the NPPES registry on June 26, 2019.

Q: What is Lucas Vandermyde's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Lucas Vandermyde was last updated on February 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.

Active since June 26, 2019

4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191(702) 653-2273 Get Directions Write a Review

NPPES record last updated: February 20, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 20, 2025, Sep 16, 2021 (2 updates tracked since 2021).

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About Lucas R Vandermyde Do NPPES

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

LUCAS R VANDERMYDE DO (NPI 1164083523) is an individual family medicine provider in Nellis Afb, Nevada, licensed in Nebraska (2472) and active in the NPI registry since June 2019.

NPPES Registry Identity

NPI1164083523

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameLUCAS R VANDERMYDECredential: DO

Location Address4700 LAS VEGAS BLVD NNellis Afb, NV 89191-6600

Mailing Address4700 Las Vegas Blvd NNellis Afb, NV 89191-6600 · (702) 653-2273

Phone(702) 653-2273

Sole ProprietorNo

Enumeration DateJune 26, 2019

Last NPPES UpdateFebruary 20, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 20, 2025

✔ NPI 1164083523 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in NE · 2472

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

4700 LAS VEGAS BLVD N, Nellis Afb, NV 89191

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DEBRA A KOENIGSBERGER MD

Integrative Medicine