Individual provider Active NPI

Lisa Vandermeer

  • Physical Therapist
  • Indianapolis, IN
National Provider Identifier
1417303470
Registry record updated May 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05003932A Issued in IN
Practice address
8028 Sargent RDG
Indianapolis, IN 46256-1873
Phone
(317) 796-0671
NPI assigned
May 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 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 05003932A IN Primary

Addresses

Primary practice location

8028 Sargent RDG
Indianapolis, IN 46256-1873

Mailing address

8028 Sargent RDG
Indianapolis, IN 46256-1873
Phone (317) 796-0671

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
05003932AINMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462752000000",
    "number": "1417303470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8028 SARGENT RDG",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561873",
            "telephone_number": "317-796-0671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8028 SARGENT RDG",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462561873",
            "telephone_number": "317-796-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMEER",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2016-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05003932A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2016; 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.