Active NPI
Julie Lynne Vanderhart, M.S.P.T.
- Physical Therapist
- Grand Rapids, MI
National Provider Identifier
1790911253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501010502
- Practice address
- 1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336 - Phone
- (616) 474-2151
- NPI assigned
- Jun 10, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5501010502 | MI | Primary |
Addresses
Primary practice location
1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336
Mailing address
4339 Applewood CT SW
Wyoming, MI 49418-8781
Phone (616) 261-4323
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5501010502 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1244592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1244592000000",
"number": "1790911253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4339 APPLEWOOD CT SW",
"city": "WYOMING",
"state": "MI",
"postal_code": "494188781",
"telephone_number": "616-261-4323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1490 E BELTLINE AVE SE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495064336",
"telephone_number": "616-474-2151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERHART",
"first_name": "JULIE",
"middle_name": "LYNNE",
"credential": "M.S.P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-06-10",
"last_updated": "2009-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501010502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.