Kim Vandevoort

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

97109 Issued in IA

Practice address

928 Main St
Keokuk, IA 52632-4655

Phone

(319) 524-4397

NPI assigned

Oct 26, 2015

Last updated

Oct 26, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alcohol & Drug Dependency Services

  • Substance Abuse Rehabilitation Facility
  • Burlington, IA
  • NPI 1013938091
  NPD (past)
• Alcohol & Drug Dependency Services

  • Substance Abuse Rehabilitation Facility
  • Wapello, IA
  • NPI 1043486400
  NPD (past)
• Alcohol & Drug Dependency Services

  • Substance Abuse Rehabilitation Facility
  • Keokuk, IA
  • NPI 1386810646
  NPD (past)
• Alcohol & Drug Dependency Services

  • Substance Abuse Rehabilitation Facility
  • Mt Pleasant, IA
  • NPI 1457527715
  NPD (past)

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

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1801268107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 MAIN ST",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526324655",
            "telephone_number": "319-524-4397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 MAIN ST",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526324655",
            "telephone_number": "319-524-4397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEVOORT",
        "first_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "97109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri-State Radiology, PC
• Twin Rivers Inc. (River Hills Village)
• Twin Rivers, Inc. (River Hills Village)
• Unlimited Development, Inc. (Keokuk Village Drive, LLC River Hills Village)
• John Vance, DC
• Wal-Mart Stores, Inc. (Vision Center 30-1431)
• Walgreen Co (Walgreens #05886)
• Walmart Inc. (Walmart Pharmacy 10-1431)
• Amanda L Walrath, PT
• Jamey Lee Washburn, ARNP

• Addiction (Substance Use Disorder) Counselor in Keokuk, IA
• Providers in Keokuk, IA by specialty
• Addiction (Substance Use Disorder) Counselor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.