Individual provider Active NPI

Marieke Van Der Horst, P.T.

  • Physical Therapist
  • Ormond Beach, FL
National Provider Identifier
1386620235
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT18940 Issued in FL
Practice address
26 N Beach St
Suite B
Ormond Beach, FL 32174-5663
Phone
(386) 673-0201
Fax
(386) 677-8143
NPI assigned
Dec 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT18940 FL Primary

Addresses

Primary practice location

26 N Beach St
Suite B
Ormond Beach, FL 32174-5663

Mailing address

504 Briar Oak Way
Deland, FL 32724-8043
Phone (386) 848-3091

Other identifiers 2

IdentifierTypeStateIssuer
P00165078OtherFLRAILROAD MEDICARE PIN
Y9430OtherFLBCBS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT18940FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Neuropathy & Pain Centers Inc PastSince Sep 10, 2012 Accepting new patients
Complete Wellness Chiropractic Center of Deland LLC Physical Therapist PastSince Sep 15, 2010 Accepting new patients
Wittmer Clinic of Chiropratic PA PastSince Jan 15, 2024 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1386620235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "504 BRIAR OAK WAY",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327248043",
            "telephone_number": "386-848-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 N BEACH ST",
            "address_2": "SUITE B",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745663",
            "telephone_number": "386-673-0201",
            "fax_number": "386-677-8143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DER HORST",
        "first_name": "MARIEKE",
        "name_prefix": "Ms.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT18940",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "P00165078",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Y9430",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ormond Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.