John J. Vanderbilt Jr., MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0PT24958 Issued in CA

Practice address

107 S Harding Blvd
Suite B
Roseville, CA 95678-3354

Phone

(916) 879-7867

Fax

(916) 435-4970

NPI assigned

Oct 24, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Burger Physical Therapy and Rehabilitation Agency Inc

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Folsom, CA
  • NPI 1457333908
  NPD (past)

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1679657985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 KLAMATH DR",
            "city": "ROCKLIN",
            "state": "CA",
            "postal_code": "957655202",
            "telephone_number": "916-879-7867",
            "fax_number": "916-435-4970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S HARDING BLVD",
            "address_2": "SUITE B",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956783354",
            "telephone_number": "916-879-7867",
            "fax_number": "916-435-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERBILT",
        "first_name": "JOHN",
        "middle_name": "J.",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "0PT24958",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0249580",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Narvaez Van Winkle, O.D.
• Phuong Van-Khieu
• Kelsey Vandenborn, PMHNP
• Monique A Vandenbos, M.A., LMFT
• Vanderbilt Physical Therapy
• McKenna Vanderhaegen
• Penny Robillard Vandestreek, D.O.
• Frankie Vang
• Iaoo Vang, LCSW
• Sheng Linda Vang

• Physical Therapist in Roseville, CA
• Providers in Roseville, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.