Kurt Ronald Vander Ploeg, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20762 Issued in IA

Practice address

615 Washington St
Pella, IA 50219-1538

Phone

(641) 628-2222

Fax

(641) 628-2915

NPI assigned

Aug 28, 2005

Reactivated

Mar 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1125187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1871586594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WASHINGTON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191538",
            "telephone_number": "641-628-2222",
            "fax_number": "641-628-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WASHINGTON ST",
            "city": "PELLA",
            "state": "IA",
            "postal_code": "502191538",
            "telephone_number": "641-628-2222",
            "fax_number": "641-628-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER PLOEG",
        "first_name": "KURT",
        "middle_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-28",
        "last_updated": "2023-03-07",
        "deactivation_date": "2006-03-23",
        "reactivation_date": "2006-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "20762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS & BLU",
            "identifier": "13768",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "16D0383065",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137687",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHN DEERE HEALTHCARE",
            "identifier": "IA0101",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Galyn W Vande Zande, DO
• Dale Vander Broek, DO
• Nancy A Vander Broek, DO
• Thomas Bernard Vander Linden, RPH.
• Troy Vander Molen, PT
• David J Vanderhoff
• Wayne Vanderleest, O.D.
• Russell R Vanhemert, D.C., C.C.S.P.
• Donna L. Vanvark, RPH
• Myndi Marie Vanvoorst, OCCUPT. THERAPIST

• Family Medicine Physician in Pella, IA
• Providers in Pella, IA by specialty
• Family Medicine Physician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.