Active NPI
Thomas Vandervelde
- Pharmacist
- Fort Myers, FL
National Provider Identifier
1891475281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 64131
- Practice address
- 13681 Doctors Way
Fort Myers, FL 33912-4300 - Phone
- (239) 343-1000
- NPI assigned
- Jul 20, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302413587 | MI | |
| Pharmacist | 183500000X | 64131 | FL | Primary |
Addresses
Primary practice location
13681 Doctors Way
Fort Myers, FL 33912-4300
Mailing address
3623 SW 2ND LN
Cape Coral, FL 33991-1008
Phone (913) 952-5943
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 |
|---|---|---|---|
| 64131 | FL | MD | Pharmacist |
| 5302413587 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689811200000",
"number": "1891475281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3623 SW 2ND LN",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339911008",
"telephone_number": "913-952-5943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13681 DOCTORS WAY",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339124300",
"telephone_number": "239-343-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERVELDE",
"first_name": "THOMAS",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-20",
"last_updated": "2023-07-20",
"certification_date": "2023-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302413587",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "64131",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.