Active NPI
Rebecca Vanderloop
- Massage Therapist
- Fond Du Lac, WI
National Provider Identifier
1427473883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 3047-146
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 10816-146 | WI | MD | Massage Therapist |
| 2742-146 | WI | MD | Massage Therapist |
| 3047-146 | WI | MD | Massage Therapist |
| 4559-146 | WI | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Massage Therapist
- Fond Du Lac, WI
- NPI 1467877837
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.