Active NPI
Steve Mark Vandenberg
- Physical Therapist
- Northville, MI
National Provider Identifier
1487816542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501003071
- Practice address
- 235 E Main St
104
Northville, MI 48167-2494 - Phone
- (248) 349-5050
- NPI assigned
- Jun 30, 2008
- Last updated
- Jun 30, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501003071 | MI | Primary |
Addresses
Primary practice location
235 E Main St
104
Northville, MI 48167-2494
Mailing address
235 E Main St
104
Northville, MI 48167-2494
Phone (248) 349-5050
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 |
|---|---|---|---|
| 5501003071 | MI | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diamond Home Health Care, Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba EverHome Skilled Home Health Care
- Home Health Agency
- Plymouth, MI
- NPI 1770529570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214784000000",
"number": "1487816542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 E MAIN ST",
"address_2": "104",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481672494",
"telephone_number": "248-349-5050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 E MAIN ST",
"address_2": "104",
"city": "NORTHVILLE",
"state": "MI",
"postal_code": "481672494",
"telephone_number": "248-349-5050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDENBERG",
"first_name": "STEVE",
"middle_name": "MARK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-30",
"last_updated": "2008-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501003071",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.