Individual provider Active NPI

Kristopher Marc Vanhouten, D.P.T.

  • Physical Therapist
  • Des Moines, IA
National Provider Identifier
1902863475
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT 29731 Issued in CA
Practice address
1515 Linden St.
Floor 1
Des Moines, IA 50309-3020
Phone
(515) 288-0569
Fax
(515) 288-0347
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT 29731 CA Primary

Addresses

Primary practice location

1515 Linden St.
Floor 1
Des Moines, IA 50309-3020

Mailing address

1515 Linden St.
Floor 1
Des Moines, IA 50309-3020
Phone (515) 288-0569

Other identifiers 1

IdentifierTypeStateIssuer
1033289749MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160510001738 IA Practitioner - Physical Therapist in Private Practice 8123081288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Therapy Services LLCGroup PAC ID 9335360130, 10 clinicians

Practice addresses (Care Compare)

1515 Linden St
Suite 101
Des Moines, IA 50309-3120
Phone (515) 288-0569

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT 29731CAMDPhysical Therapist
29731CAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Therapy Services LLC Physical Therapist CurrentSince Apr 18, 2016 Accepting new patients
Integrated Physical Therapy and Sports Medicine PLLC Physical Therapist PastSince Jan 1, 2013 Accepting new patients
Carmel Orthopedic & Sports Therapy Physical Therapist Past Accepting new patients
Carmel Orthopedic & Sports Therapy Physical Therapist Past Accepting new patients

Locations

2222 SW Vintage Pkwy
Ste A
Ankeny, IA 50023
Phone (515) 657-7186

1515 Linden St
Ste 101
Des Moines, IA 50309
Phone (515) 288-0569

6151 Thornton Ave
Ste 300
Des Moines, IA 50321
Phone (515) 288-0569

1515 Linden St
Fl 1
Des Moines, IA 50309
Phone (515) 288-0569

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1902863475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 LINDEN ST.",
            "address_2": "FLOOR 1",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503093020",
            "telephone_number": "515-288-0569",
            "fax_number": "515-288-0347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 LINDEN ST.",
            "address_2": "FLOOR 1",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503093020",
            "telephone_number": "515-288-0569",
            "fax_number": "515-288-0347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANHOUTEN",
        "first_name": "KRISTOPHER",
        "middle_name": "MARC",
        "name_prefix": "Mr.",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 29731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033289749",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.