Robin Gene Vandeventer

Primary specialty

CounselorTaxonomy code 101Y00000X

License

88000671A Issued in IN

Practice address

2200 Lake Ave Ste 225
Fort Wayne, IN 46805-5364

Phone

(260) 436-0932

Fax

(260) 436-1185

NPI assigned

Sep 18, 2018

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)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: robin.vandeventer.p1@direct.meridianhs.nextgenshare.com

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

{
    "created_epoch": "1537228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537228800000",
    "number": "1114401080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 N TILLOTSON AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473043988",
            "telephone_number": "765-288-1928",
            "fax_number": "765-741-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 LAKE AVE STE 225",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468055364",
            "telephone_number": "260-436-0932",
            "fax_number": "260-436-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEVENTER",
        "first_name": "ROBIN",
        "middle_name": "GENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-18",
        "last_updated": "2018-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IN",
            "license": "88000671A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MENTAL HEALTH ASSOCIATE LICENSE",
            "identifier": "88000671A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "14329568",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cynthia L. Vanderbosch, M.D.
• Trever Vanderhorst, MD
• Craig William Vandermaden, PTA
• Emily Nicole Vandermaden, DPT
• Kathleen Vanderreyden, NP
• Natalie Vandezande
• Vance V Vandrake, MD
• Michelle L Vanek, PTA
• Erika J Vanengen, PT
• Grace Vangessel

• Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.