DR. GARY VANN (PH.D.) – Psychologist, NPI 1376634519

DR. GARY VANN (PH.D.) is a healthcare provider. based in Traverse city, Michigan. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. 008156 (MI). The NPI Number for DR. GARY VANN (PH.D.) is 1376634519

Main info

Male
Sole Proprietor
35 Years Of Experience
Accepts Medicare Assignment
Name
DR. GARY VANN (PH.D.)
NPI
1376634519
Phone
(231) 947-2990
Address
13561 SOUTH WEST BAYSHORE DRIVE
Enumeration Date
27 September 2006
Last Update Date
5 November 2015

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2319440512
Graduation Year
1991 (35 years ago)
PAC ID
4082898333
Professional Enrollment ID
I20110411000426
Address ID
MI496844564TR3301XDRXX303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,216 CLINICAL PSYCHOLOGIST in MI

Provider Addresses for DR. GARY VANN (PH.D.)

  • 13561 SOUTH WEST BAYSHORE DRIVE

    STE 317

    TRAVERSE CITY, MI 49684

    Phone: (231) 947-2990

    Fax: (231) 947-5862

    Type: Mailing

  • 13561 SOUTH WEST BAYSHORE DR.

    STE. 317

    TRAVERSE CITY, MI 49684

    Phone: (231) 947-2990

    Fax: (231) 947-5862

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-04-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110411000426IClinical PsychologistMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 49684)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. GARY VANN (PH.D.)?
DR. GARY VANN (PH.D.) — NPI 1376634519 — is the standard way to identify this listing.
Is DR. GARY VANN (PH.D.) listed as active for patients and plans?
The listing shows DR. GARY VANN (PH.D.) as active in the NPI system.
What taxonomy line describes DR. GARY VANN (PH.D.)?
For research purposes, treat DR. GARY VANN (PH.D.) as Psychologist in this dataset. Clinical services aligned with this taxonomy classification.
Does DR. GARY VANN (PH.D.) list a practice location?
Patients near Traverse City, Michigan may find DR. GARY VANN (PH.D.) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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