Individual provider Active NPI

Rebecca Vanderloop

  • Massage Therapist
  • Fond Du Lac, WI
National Provider Identifier
1427473883
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
3047-146 Issued in WI
Practice address
976 E Johnson St Ste 900
Fond Du Lac, WI 54935-9747
Phone
(920) 539-8289
NPI assigned
Feb 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 3047-146 WI Primary
Massage Therapist 225700000X 10816-146 WI
Massage Therapist 225700000X 4559-146 WI
Massage Therapist 225700000X 2742-146 WI

Addresses

Primary practice location

976 E Johnson St Ste 900
Fond Du Lac, WI 54935-9747

Mailing address

PO Box 85
Mayville, WI 53050-0085
Phone (920) 539-8289

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
10816-146WIMDMassage Therapist
2742-146WIMDMassage Therapist
3047-146WIMDMassage Therapist
4559-146WIMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
No Knots Therapeutic Massage Massage Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1392940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1427473883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 85",
            "city": "MAYVILLE",
            "state": "WI",
            "postal_code": "530500085",
            "telephone_number": "920-539-8289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 E JOHNSON ST STE 900",
            "city": "FOND DU LAC",
            "state": "WI",
            "postal_code": "549359747",
            "telephone_number": "920-539-8289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERLOOP",
        "first_name": "REBECCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-21",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "3047-146",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "10816-146",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "4559-146",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WI",
            "license": "2742-146",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; 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.