Individual provider Active NPI

Andrea Deweerdt, FNP

  • Family Nurse Practitioner
  • Zeeland, MI
National Provider Identifier
1417250028
Registry record updated Apr 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704246576 Issued in MI
Practice address
8300 Westpark Way
Zeeland, MI 49464-7901
Phone
(616) 772-7314
NPI assigned
Dec 21, 2010
Last updated
Apr 18, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2017

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 4704246576 MI Primary

Addresses

Primary practice location

8300 Westpark Way
Zeeland, MI 49464-7901

Mailing address

8300 Westpark Way
Zeeland, MI 49464-7901
Phone (616) 772-7314

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
Credentials
Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: andrea.deweerdt.1@31044.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492473600000",
    "number": "1417250028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 WESTPARK WAY",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494647901",
            "telephone_number": "616-772-7314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8300 WESTPARK WAY",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494647901",
            "telephone_number": "616-772-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEERDT",
        "first_name": "ANDREA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-21",
        "last_updated": "2017-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704246576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zeeland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; 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.