Nathan Vanderwoude, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT5558 Issued in ME

Practice address

23 Cedar Ridge Dr
Skowhegan, ME 04976-4160

Phone

(207) 474-9686

NPI assigned

Mar 8, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1583625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1871128058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 S WILLOW ST",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031035714",
            "telephone_number": "800-995-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CEDAR RIDGE DR",
            "city": "SKOWHEGAN",
            "state": "ME",
            "postal_code": "049764160",
            "telephone_number": "207-474-9686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWOUDE",
        "first_name": "NATHAN",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-08",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007781",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "043826",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT5558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Skowhegan, ME
• Providers in Skowhegan, ME by specialty
• Physical Therapist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2020; 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.