Lillian R Van Gelderen

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502008525 Issued in MI

Practice address

1423 W Centre Ave
Portage, MI 49024-5323

Phone

(269) 323-4300

NPI assigned

Dec 27, 2022

Last updated

Dec 30, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ivyrehab Michigan, LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Fenton, MI
  • NPI 1104337120
  NPD
• Physical Therapy One, P.C.

  • Physical Therapist
  • Portage, MI
  • NPI 1962499855

  Physical Therapy Assistant

  NPD (past)

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767052800000",
    "number": "1932812674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 KENNEDY BLVD",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "49093",
            "telephone_number": "231-923-8322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1423 W CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245323",
            "telephone_number": "269-323-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN GELDEREN",
        "first_name": "LILLIAN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2025-12-30",
        "certification_date": "2025-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502008525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Uttermohlen
• V&a Bootery Inc
• Yelba Yelitza Pineda Vallecillo, BCBA
• Ray Christian Van de Walker, D.C.
• Anthony J Van Es, MD
• Nathan Douglas Van Hofwegen, D.D.S.
• Roger Allan Vander Beek, D.D.S.
• Dan J Vandermeulen, DDS MS
• Mark Vandermyde
• Ciara Vanderploeg, PHD

• Physical Therapy Assistant in Portage, MI
• Providers in Portage, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2025; 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.