NPIMap

Organization Active NPI

Tipton Adaptive Daycare LLC

  • Registered Nurse
  • Tipton, IA
National Provider Identifier
1932475142
Registry record updated Apr 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
104423 Issued in IA
Legal business name
TIPTON ADAPTIVE DAYCARE LLC
Practice address
118 Parkview CT
Tipton, IA 52772-1349
Phone
(563) 886-3143
Fax
(563) 886-3143
NPI assigned
Apr 2, 2012
Last updated
Apr 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2012

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

Authorized official

Name
Mrs. Deborah Lorraine Vandergaast, RNNPI 1023233806
Title
Owner / Director
Phone
(563) 886-3143

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X 104423 IA
Child Physical Disabilities Respite Care 385HR2065X 104423 IA
Registered Nurse 163W00000X 104423 IA Primary

Addresses

Primary practice location

118 Parkview CT
Tipton, IA 52772-1349

Mailing address

118 Parkview CT
Tipton, IA 52772-1349
Phone (563) 886-3143

Other identifiers 1

IdentifierTypeStateIssuer
1023233806MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333324800000",
    "number": "1932475142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 PARKVIEW CT",
            "city": "TIPTON",
            "state": "IA",
            "postal_code": "527721349",
            "telephone_number": "563-886-3143",
            "fax_number": "563-886-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 PARKVIEW CT",
            "city": "TIPTON",
            "state": "IA",
            "postal_code": "527721349",
            "telephone_number": "563-886-3143",
            "fax_number": "563-886-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIPTON ADAPTIVE DAYCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A",
        "authorized_official_last_name": "VANDERGAAST",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "LORRAINE",
        "authorized_official_title_or_position": "OWNER / DIRECTOR",
        "authorized_official_telephone_number": "563-886-3143",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "IA",
            "license": "104423",
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": "IA",
            "license": "104423",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IA",
            "license": "104423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023233806",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tipton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.