Individual provider Active NPI

Krysta Vanderveen

  • Speech-Language Pathologist
  • Hudsonville, MI
National Provider Identifier
1619872975
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
7101002692 Issued in MI
Practice address
2950 Baldwin St
Hudsonville, MI 49426-8609
Phone
(616) 777-6534
NPI assigned
Oct 8, 2026
Last updated
Oct 8, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 7101002692 MI Primary

Addresses

Primary practice location

2950 Baldwin St
Hudsonville, MI 49426-8609

Mailing address

8375 20TH Ave
Jenison, MI 49428-9230
Phone (616) 457-8890

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
7101002692MIMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1791417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791417600000",
    "number": "1619872975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8375 20TH AVE",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494289230",
            "telephone_number": "616-457-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 BALDWIN ST",
            "city": "HUDSONVILLE",
            "state": "MI",
            "postal_code": "494268609",
            "telephone_number": "616-777-6534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVEEN",
        "first_name": "KRYSTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-08",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MI",
            "license": "7101002692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudsonville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; 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.