Pamela Vandusen, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704165365 Issued in MI

Practice address

200 Jefferson SE
Grand Rapids, MI 49503

Phone

(616) 685-1835

Fax

(616) 685-1846

NPI assigned

May 26, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Metropolitan Hospital

  • General Acute Care Hospital
  • Wyoming, MI
  • NPI 1619923919
  NPD (past)

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1700832995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 44TH ST SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "49508",
            "telephone_number": "616-965-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JEFFERSON SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "49503",
            "telephone_number": "616-685-1835",
            "fax_number": "616-685-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDUSEN",
        "first_name": "PAMELA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704165365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700832995",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Vandriel, RN, IBCLC
• Lauren Vandrunen, LMSW
• Carly Vanduinen
• Joni Vanduinen, DO
• Emily Vanduren
• Sarah Ann Vandyke-Velasquez, PH.D.
• Anna Nicole Vandyke, DNP, FNP-C
• Brent Ward Vandyke, PA-C
• David Aaron Vandyke, M.D.
• Emily Vandyke

• 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 Apr 1, 2014; 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.