Individual provider Active NPI

Myndi Marie Vanvoorst, OCCUPT. THERAPIST

  • Occupational Therapist
  • Pella, IA
National Provider Identifier
1033176326
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
01218 Issued in IA
Practice address
2525 Washington St
Pella, IA 50219-1553
Phone
(641) 621-1401
Fax
(641) 628-7308
NPI assigned
Apr 28, 2006
Last updated
Jan 29, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 01218 IA Primary

Addresses

Primary practice location

2525 Washington St
Pella, IA 50219-1553

Mailing address

2525 Washington St
Pella, IA 50219-1553
Phone (641) 621-1401

Other identifiers 1

IdentifierTypeStateIssuer
01218OtherIAIOWA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1033176326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 WASHINGTON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191553",
            "telephone_number": "641-621-1401",
            "fax_number": "641-628-7308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 WASHINGTON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191553",
            "telephone_number": "641-621-1401",
            "fax_number": "641-628-7308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANVOORST",
        "first_name": "MYNDI",
        "middle_name": "MARIE",
        "credential": "OCCUPT. THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-28",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IA",
            "license": "01218",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IOWA LICENSE",
            "identifier": "01218",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pella, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.