Lowell M Vantassel, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501002464 Issued in MI

Practice address

960 Razorback Dr Ste 3
Houghton, MI 49931-2830

Phone

(906) 482-8201

Fax

(906) 482-2771

NPI assigned

Jul 3, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• L Mark Vantassel Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1679913776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 OSCEOLA ST",
            "city": "LAURIUM",
            "state": "MI",
            "postal_code": "499132134",
            "telephone_number": "906-337-6500",
            "fax_number": "906-337-6597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 RAZORBACK DR STE 3",
            "city": "HOUGHTON",
            "state": "MI",
            "postal_code": "499312830",
            "telephone_number": "906-482-8201",
            "fax_number": "906-482-2771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANTASSEL",
        "first_name": "LOWELL",
        "middle_name": "M",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-03",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501002464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "L",
            "last_name": "VANTASSEL",
            "middle_name": "MARK",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• All providers in Houghton, MI
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.