Individual provider Active NPI

Angela Joan Vanderkarr, FNP-C

  • Family Nurse Practitioner
  • Roscommon, MI
National Provider Identifier
1154043040
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704342988 Issued in MI
Practice address
234 Lake St
Roscommon, MI 48653-9203
Phone
(989) 275-1200
NPI assigned
Sep 16, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704342988 MI Primary

Addresses

Primary practice location

234 Lake St
Roscommon, MI 48653-9203

Mailing address

234 Lake St
Roscommon, MI 48653-9203
Phone (989) 275-1200

Other practice location 1

1250 E Michigan Ave
Grayling, MI 49738-7074
Phone (989) 348-0550

Other practice location 2

1200 W North Down River Rd Ste C
Grayling, MI 49738-8024
Phone (989) 344-5910

Other identifiers 1

IdentifierTypeStateIssuer
4704342988OtherMIDEPARTMENT OF LICENSING AND REGULATORY AFFAIRS

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address avanderkarr@direct.mhc.net

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
I20230109000942 MI Practitioner - Nurse Practitioner 3779953732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northsport Physical Therapy and Rehabilitation P CGroup PAC ID 5294902508, shared by 2 NPIs, 43 clinicians
Munson Healthcare GraylingGroup PAC ID 2062736655, 64 clinicians

Practice addresses (Care Compare)

1622 Dickerson Rd
Gaylord, MI 49735-9206

234 Lake St
Roscommon, MI 48653-9203
Phone (989) 275-1200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704342988MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Grayling CurrentSince Oct 10, 2022 Accepting new patients
Munson Healthcare Grayling Current Accepting new patients
Munson Healthcare Grayling CurrentSince Oct 10, 2022 Accepting new patients
Munson Healthcare Grayling Past Accepting new patients

Locations

3781 Momentum Pl
Chicago, IL 60689

1200 W North Down River Rd
Ste C
Grayling, MI 49738
Phone (231) 935-6455

1250 E Michigan Ave
Grayling, MI 49738
Phone (989) 348-0550

234 Lake St
Roscommon, MI 48653
Phone (517) 275-1200

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Interoperability endpoints

  • Direct secure messaging: avanderkarr@direct.mhc.net

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 6

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1154043040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 LAKE ST",
            "city": "ROSCOMMON",
            "state": "MI",
            "postal_code": "486539203",
            "telephone_number": "989-275-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 LAKE ST",
            "city": "ROSCOMMON",
            "state": "MI",
            "postal_code": "486539203",
            "telephone_number": "989-275-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 E Michigan Ave",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497387074",
            "country_code": "US",
            "telephone_number": "989-348-0550",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 W North Down River Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Grayling",
            "state": "MI",
            "postal_code": "497388024",
            "country_code": "US",
            "telephone_number": "989-344-5910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERKARR",
        "first_name": "ANGELA",
        "middle_name": "JOAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704342988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS",
            "identifier": "4704342988",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "avanderkarr@direct.mhc.net",
            "affiliation": "N",
            "address_1": "234 Lake St",
            "city": "Roscommon",
            "state": "MI",
            "country_code": "US",
            "postal_code": "486539203",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roscommon, MI

Sources for this page

Verify at the official NPI Registry.