Active NPI
Megan Rachelle Vanderkamp
- Physician Assistant
- Grand Rapids, MI
National Provider Identifier
1003516048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601009229
- Practice address
- 119 Prospect Ave NE
Grand Rapids, MI 49503-3379 - Phone
- (616) 826-3174
- NPI assigned
- Mar 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601009229 | MI | Primary |
Addresses
Primary practice location
119 Prospect Ave NE
Grand Rapids, MI 49503-3379
Mailing address
119 Prospect Ave NE
Grand Rapids, MI 49503-3379
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601009229 | MI | MD | Physician Assistant |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678233600000",
"number": "1003516048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 PROSPECT AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495033379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 PROSPECT AVE NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495033379",
"telephone_number": "616-826-3174"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERKAMP",
"first_name": "MEGAN",
"middle_name": "RACHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-08",
"last_updated": "2023-03-08",
"certification_date": "2023-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601009229",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.