Brittany Vander Kooy

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95012582 Issued in CA

Practice address

3333 Concours St BLDG 6 Suite 100
Ontario, CA 91764-2347

Phone

(909) 481-3242

NPI assigned

Mar 10, 2020

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

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• West Coast Wound and Skin Care Inc

  • Surgery Physician
  • Burbank, CA
  • NPI 1437675980
  Medicare reassignment NPD

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633219200000",
    "number": "1831724871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 MAGNOLIA AVE UNIT 406",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925054889",
            "telephone_number": "949-939-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CONCOURS ST BLDG 6 SUITE 100",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917642347",
            "telephone_number": "909-481-3242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER KOOY",
        "first_name": "BRITTANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2021-10-03",
        "certification_date": "2021-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95012582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Valov
• Annaliza Paraiso Valtier
• Elvira Van Der Burg
• Raquel Van Diest
• Lindsey Van Hofwegen, M.S., CCC-SLP
• Adam Miguel Vanegas I
• Erica Vang
• Daniel John Vann White
• Elan Vanterpool
• Priscilla Vara

• Nurse Practitioner in Ontario, CA
• Providers in Ontario, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.