Nancy A Vander Broek, DO

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

02420 Issued in IA

Practice address

405 Monroe St
Pella, IA 50219-1189

Phone

(641) 628-3832

Fax

(641) 628-8894

NPI assigned

Mar 10, 2006

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192406400000",
    "number": "1679541072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MONROE ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191189",
            "telephone_number": "641-628-3832",
            "fax_number": "641-628-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 MONROE ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191189",
            "telephone_number": "641-628-3832",
            "fax_number": "641-628-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER BROEK",
        "first_name": "NANCY",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-10",
        "last_updated": "2007-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IA",
            "license": "02420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1064832",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080099542",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Wayne Van Wyk, D.C.
• Tereasa L. Van Zee, DO
• Robin L. Vande Voort, MD
• Galyn W Vande Zande, DO
• Dale Vander Broek, DO
• Thomas Bernard Vander Linden, RPH.
• Troy Vander Molen, PT
• Kurt Ronald Vander Ploeg, M.D.
• David J Vanderhoff
• Wayne Vanderleest, O.D.

• General Practice Physician in Pella, IA
• Providers in Pella, IA by specialty
• General Practice Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.