Karin Vannieuwenhuizen, P.A.-C

Primary specialty

Emergency Medical Services (Emergency Medicine) PhysicianTaxonomy code 207PE0004X

License

2130 Issued in AZ

Practice address

1003 Willow Creek Rd
Prescott, AZ 86301-1641

Phone

(928) 445-2700

NPI assigned

May 28, 2006

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Progressive Medical Associates PLLC

  • Emergency Medicine Physician
  • Mesa, AZ
  • NPI 1548218613
  NPD (past)

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

{
    "created_epoch": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063469781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2291 ALTA VISTA PL",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863015350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WILLOW CREEK RD",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011641",
            "telephone_number": "928-445-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNIEUWENHUIZEN",
        "first_name": "KARIN",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "AZ",
            "license": "2130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "456104",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Vanderkooi, DPT
• Derek Vanderroest, PTA
• Hannah Vanderroest, RN
• Vanguard Medical Associates, PLLC
• Megan L. Vanmeter, ATR-BC, LPC-AT/S, &
• Vantage Cancer Care - Arizona, S.C.
• Vantage Cancer Care Network of Arizona, S.C.
• Candy Lyn Varaksin, RRT
• Clyde R Varner, MD
• Terry Anne Vaughan, MD

• Emergency Medical Services (Emergency Medicine) Physician in Prescott, AZ
• Providers in Prescott, AZ by specialty
• Emergency Medical Services (Emergency Medicine) Physician in Arizona

• 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.