Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Randy Paul Vawdrey, NP

Individual provider Primary Care Nurse Practitioner · NPI 1376568493

Mr. Randy Paul Vawdrey, NP is a Nurse Practitioner in Pocatello, Idaho. Qualified in 2004, 22 years ago. Practices with Mvh Pic LLC, a 16-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
22
Licensed in
ID
In the registry since
2006
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

495 Yellowstone Ave
Pocatello, ID 83201-4531
Phone: (208) 478-7422
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Nurse Practitioner (primary) Taxonomy 363LP2300X · Licence NP-659 (ID)

Record details

NPI number1376568493
Entity typeIndividual (Type 1)
GenderMale
Credentials NP
Sole proprietorNo
NPI enumeratedJuly 12, 2006
Last updated in NPPESJuly 9, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Mvh Pic Llc — 16 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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