Individual provider Active NPI

Jodi Lynn Vandertuig, B.A

  • Social Worker
  • Grand Rapids, MI
National Provider Identifier
1043351265
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
781 36TH St SE
Grand Rapids, MI 49548-2319
Phone
(616) 248-5159
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

781 36TH St SE
Grand Rapids, MI 49548-2319

Mailing address

137 Rollingwood Dr
Rockford, MI 49341-1193
Phone (616) 633-3725

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)
Not enrolled
Credentials
Bachelor of Arts

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1043351265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 ROLLINGWOOD DR",
            "city": "ROCKFORD",
            "state": "MI",
            "postal_code": "493411193",
            "telephone_number": "616-633-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 36TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495482319",
            "telephone_number": "616-248-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERTUIG",
        "first_name": "JODI",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "B.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "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 Jul 8, 2007; 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.