Nicole J Buurma, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60011687 Issued in WA

Practice address

1824 Front Street
Ste a
Lynden, WA 98264-8708

Phone

(360) 354-0585

Fax

(360) 354-1098

NPI assigned

Aug 24, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 9

Other names 1

• Nicole J Vanderwiele Former name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lynden Family Physical Therapy PS IncGroup PAC ID 2668465253, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Lynden Family Physical Therapy PS Inc.

  • Physical Therapist
  • Lynden, WA
  • NPI 1871578682
  Medicare reassignment Care Compare group
• Occusport Services Inc.

  • Physical Therapist
  • Lockport, IL
  • NPI 1952350886
  NPD (past)

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

{
    "created_epoch": "1187913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1124211941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1824 FRONT ST STE A",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982641729",
            "telephone_number": "360-354-0585",
            "fax_number": "360-354-1098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 FRONT STREET",
            "address_2": "STE A",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982648708",
            "telephone_number": "360-354-0585",
            "fax_number": "360-354-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUURMA",
        "first_name": "NICOLE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-24",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070015873",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60011687",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R.R. MEDICARE GROUP #",
            "identifier": "CJ4383",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "GAB14760",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL GROUP NUMBER",
            "identifier": "1619908",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP#",
            "identifier": "200852",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "568080",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "202542",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "567770",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "1623066",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "US DEPT OF LABOR",
            "identifier": "367885100",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "VANDERWIELE",
            "middle_name": "J",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Shawna K Bosman, ARNP
• Harkiran Boyal
• Simran Kaur Brar
• Daniel Dale Brinkman, PSY.D.
• Margaret H. Burden, MD
• Robin W. Caldwell, MD
• Madison Lynn Canales
• Capstone Health Services Inc.
• Chelsey Blair Caraco, SLP
• Cardiotech Monitoring Systems LLC

• Physical Therapist in Lynden, WA
• Providers in Lynden, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.