Vernon Jack Vandenberg, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501001113 Issued in MI

Practice address

286 Hoover Blvd
Holland, MI 49423-3719

Phone

(616) 392-2172

Fax

(616) 392-1726

NPI assigned

Jun 29, 2006

Sex

Male

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 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Alliance Physical Therapy Group LLC

  dba Armor Physical Therapy

  • Physical Therapist
  • Holland, MI
  • NPI 1649216144
  NPD (past)

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1184652299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233719",
            "telephone_number": "616-392-2172",
            "fax_number": "616-392-1726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "286 HOOVER BLVD",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494233719",
            "telephone_number": "616-392-2172",
            "fax_number": "616-392-1726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "VERNON",
        "middle_name": "JACK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501001113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1184652299",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1649216144",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "650G011870",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "5501001113",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara Elizabeth Vandebyl, LMSW, ACSW
• Elisabeth Joy Vandenberg, MA, LLPC
• Joanne Beth Vandenberg, MA, LLP
• Kelly Irene Vandenberg
• Sara Vandenberg
• Amber Lynn Vandenbos, APN
• Stacy Vandenbrand
• Sarah E Vandenheuvel, LMSW
• Tony Vandenhoek
• Brett Thomas Vander Baan, MD

• Physical Therapist in Holland, MI
• Providers in Holland, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; 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.