Individual provider Active NPI

Erica Michelle Vantuyl, PT,DPT

  • Physical Therapist
  • Dowagiac, MI
National Provider Identifier
1043714058
Registry record updated Mar 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501017833 Issued in MI
Practice address
420 W High St
Dowagiac, MI 49047-1943
Phone
(269) 783-3041
Fax
(269) 783-3019
NPI assigned
Mar 23, 2018
Last updated
Mar 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501017833 MI Primary

Addresses

Primary practice location

420 W High St
Dowagiac, MI 49047-1943

Mailing address

420 W High St
Dowagiac, MI 49047-1996
Phone (269) 783-3041

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

State licenses

LicenseStateTypeSpecialty
5501017833MIMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1521763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1043714058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 W HIGH ST",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490471996",
            "telephone_number": "269-783-3041",
            "fax_number": "269-783-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 W HIGH ST",
            "city": "DOWAGIAC",
            "state": "MI",
            "postal_code": "490471943",
            "telephone_number": "269-783-3041",
            "fax_number": "269-783-3019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTUYL",
        "first_name": "ERICA",
        "middle_name": "MICHELLE",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-23",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501017833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dowagiac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.