Individual provider Active NPI

Wouter Vanderhorst, P.T.

  • Physical Therapist
  • Clearwater, FL
National Provider Identifier
1396740890
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0007949 Issued in FL
Practice address
14141 46TH N St 1202
Clearwater, FL 33762-3860
Phone
(727) 535-6746
Fax
(727) 536-6006
NPI assigned
Jun 20, 2005
Last updated
Mar 28, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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 PT0007949 FL Primary

Addresses

Primary practice location

14141 46TH N St 1202
Clearwater, FL 33762-3860

Mailing address

2033 Long Branch LN
Clearwater, FL 33760-1960
Phone (727) 524-6162

Other identifiers 1

IdentifierTypeStateIssuer
88645300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160503000909 FL Practitioner - Physical Therapist in Private Practice 0648164830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14141 46TH St N
Clearwater, FL 33762-3860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT0007949FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healing the Generations, Inc. Physical Therapist CurrentSince Mar 28, 2001 Accepting new patients

Locations

14141 46th St N
Ste 1202
Clearwater, FL 33762
Phone (727) 535-6746

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1396740890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2033 LONG BRANCH LN",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337601960",
            "telephone_number": "727-524-6162",
            "fax_number": "727-536-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14141 46TH N ST 1202",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337623860",
            "telephone_number": "727-535-6746",
            "fax_number": "727-536-6006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERHORST",
        "first_name": "WOUTER",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT0007949",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "88645300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.