Carol Ann Vanantwerp, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

4704078169 Issued in MI

Practice address

5629 Stadium Dr
Kalamazoo, MI 49009-1952

Phone

(269) 372-1000

Fax

(269) 372-0698

NPI assigned

Oct 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222128000000",
    "number": "1043408172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "BOX 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-7806",
            "fax_number": "269-341-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5629 STADIUM DR",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490091952",
            "telephone_number": "269-372-1000",
            "fax_number": "269-372-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANANTWERP",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2008-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704078169",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "500C912770",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1043408172",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dana Van Oostenburg, M.A. CCC-SLP
• Angela Van Poppel, NP
• Stephanie Janice Van Ryn, PA-C
• Madison Lynn Van Winkle, PA-C
• Tanner Layne Van Wyhe
• Vicki L Vanas, MA LLP
• Emrielle Vancleave, LMFT
• Amy Sue Vandenberg, FNP
• Abigail Vandenbroeck
• Heather Lynne Vandenbussche, PHARM.D.

• Pediatric Nurse Practitioner in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Pediatric Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2008; 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.