Samantha Vandenberg, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704320926 Issued in MI

Practice address

4820 Cascade Rd SE Ste B
Grand Rapids, MI 49546-3785

Phone

(616) 965-9449

NPI assigned

Mar 26, 2025

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

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

{
    "created_epoch": "1742947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1629870100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4820 CASCADE RD SE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463785",
            "telephone_number": "616-965-9449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4820 CASCADE RD SE STE B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463785",
            "telephone_number": "616-965-9449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDENBERG",
        "first_name": "SAMANTHA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-26",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704320926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Vandenberg
• Jonathan Christian Vandenberg, D.O
• Michael Vandenberg, DPT
• Michelle Vandenberg, LLMSW; BLS
• Ruth Jean Vandenberg, P.A.-C.
• Stacey Lynn Vandenberg, MA, LPC, NCC, CAADC
• William Christian Vandenberg, M.D.
• Kylie Jay Vandenberge
• Stacey Michelle Vandenberge, OTR
• Amy Vandenbos

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.