Individual provider Active NPI

Amy Deen Vandesteeg, LMT

  • Other Specialist/Technologist
  • Gainesville, FL
National Provider Identifier
1235469511
Registry record updated Jan 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
License
MA 52714 Issued in FL
Practice address
6413 SW 13 St.
Gainesville, FL 32608
Phone
(904) 864-3147
NPI assigned
Jan 8, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/Technologist 246Z00000X MA 52714 FL Primary

Addresses

Primary practice location

6413 SW 13 St.
Gainesville, FL 32608

Mailing address

22433 NW 94TH Ave
Alachua, FL 32615-5915
Phone (904) 864-3147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA 52714FLMDOther Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1262908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262908800000",
    "number": "1235469511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22433 NW 94TH AVE",
            "city": "ALACHUA",
            "state": "FL",
            "postal_code": "326155915",
            "telephone_number": "904-864-3147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6413 SW 13 ST.",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32608",
            "telephone_number": "904-864-3147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEEN VANDESTEEG",
        "first_name": "AMY",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-08",
        "last_updated": "2010-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other",
            "state": "FL",
            "license": "MA 52714",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2010; 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.