Russell Allen Vande Vegte, PT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

14066 Issued in CA

Practice address

4510 Viewridge Ave
San Diego, CA 92123-1637

Phone

(858) 694-4922

NPI assigned

Jun 25, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1487850558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2509 ARNOTT ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921101152",
            "telephone_number": "619-276-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4510 VIEWRIDGE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231637",
            "telephone_number": "858-694-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDE VEGTE",
        "first_name": "RUSSELL",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "14066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Willie Jean Vance, RN
• Elise J Vanda, LCSW
• Wongaletu Vanda II, LCSW
• Aaron Thomas Vandarwarka, RADT
• Karen Leslie Vande Vegte, P.T.
• Jeffrey Vandemark, PHARMD
• Kelsey Jordan Vanden Heuvel, MS, RDN
• Michael James Vandenbroek
• Kathy Ann Vandenburgh, PH.D.
• Kelly L Vandenheuvel, MD

• Orthopedic Physical Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2021; 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.