Individual provider Active NPI

Barbara A Vandermale, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Holland, MI
National Provider Identifier
1124435276
Registry record updated Dec 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704264429 Issued in MI
Practice address
854 Washington Ave Ste 330
Holland, MI 49423-7141
Phone
(616) 355-3926
NPI assigned
Jul 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704264429 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704264429 MI Primary

Addresses

Primary practice location

854 Washington Ave Ste 330
Holland, MI 49423-7141

Mailing address

854 Washington Ave Ste 330
Holland, MI 49423-7141
Phone (616) 355-3926

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161104001418 MI Practitioner - Nurse Practitioner 5698053015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Michigan State University College of Human Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Holland Community HospitalGroup PAC ID 0446157291, 174 clinicians

Practice addresses (Care Compare)

854 Washington Ave
330 Op Behavioral Health Services
Holland, MI 49423-7141
Phone (616) 355-3926

Hospital & facility affiliations

  • Holland Hospital Hospital, Holland, MI, CCN 230072

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704264429MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Holland Community Hospital Current Accepting new patients
Holland Community Hospital CurrentSince Oct 28, 2019 Accepting new patients
Holland Community Hospital Past Accepting new patients
Holland Community Hospital Past Accepting new patients

Locations

415 Wiley Rd
Ste 102
Douglas, MI 49406
Phone (269) 857-3208

15100 Whittaker Way
Grand Haven, MI 49417
Phone (616) 935-6200

175 S Waverly Rd
Holland, MI 49423
Phone (616) 355-3896

854 Washington Ave
Bldg A
Holland, MI 49423

854 Washington Ave
Ste 330
Holland, MI 49423
Phone (616) 355-3926

577 Michigan Ave
Holland, MI 49423
Phone (616) 393-2190

577 Michigan Ave
Ste 101
Holland, MI 49423
Phone (616) 393-2190

602 Michigan Ave
Holland, MI 49423
Phone (616) 394-3350

577 Michigan Ave
Ste 104
Holland, MI 49423
Phone (616) 355-3984

3235 N Wellness Dr
Ste 120B
Holland, MI 49424
Phone (616) 399-1369

8300 Westpark Way
Zeeland, MI 49464
Phone (616) 748-5760

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671494400000",
    "number": "1124435276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "854 WASHINGTON AVE STE 330",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237141",
            "telephone_number": "616-355-3926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 WASHINGTON AVE STE 330",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494237141",
            "telephone_number": "616-355-3926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMALE",
        "first_name": "BARBARA",
        "middle_name": "A",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-21",
        "last_updated": "2022-12-20",
        "certification_date": "2022-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704264429",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704264429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

Verify at the official NPI Registry.