Kara Lynne Vanderboon, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201009654 Issued in MI

Practice address

25 Conran Drive
Coopersville, MI 49404

Phone

(616) 997-6172

NPI assigned

Aug 10, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ivyrehab Northern PT, LLC

  • Physical Therapy Clinic/Center
  • Sparta, MI
  • NPI 1972592525
  NPD (past)
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD (past)

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1497270482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2250 ELMER DRIVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CONRAN DRIVE",
            "city": "COOPERSVILLE",
            "state": "MI",
            "postal_code": "49404",
            "telephone_number": "616-997-6172"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Wealthy St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495062921",
            "country_code": "US",
            "telephone_number": "616-774-7444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDERBOON",
        "first_name": "KARA",
        "middle_name": "LYNNE",
        "name_prefix": "Miss",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201009654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Jean Sundblad Hsieh, MD
• Kimberly Tew, PA
• Cheryl Ann Thomas, LPN
• Krista Tisdel, LMSW
• Uplift Therapies, LLC
• Nicole Marie Vandussen, LMSW
• Christina Marie Vanhouten, LMSW
• Melissa Vankampen, PTA
• Dawn K Walt, OD
• Tayler Ward

• Occupational Therapist in Coopersville, MI
• Providers in Coopersville, MI by specialty
• Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.