Marc Lee Vandervelden, DPT CSCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

03548 Issued in IA

Practice address

3200 Westown Pkwy
West Des Moines, IA 50266-1110

Phone

(515) 276-1212

Fax

(515) 276-3194

NPI assigned

May 3, 2006

Last updated

Aug 7, 2012By the provider in NPPES

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344297600000",
    "number": "1972561637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3200 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661110",
            "telephone_number": "515-276-1212",
            "fax_number": "515-276-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3200 WESTOWN PKWY",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661110",
            "telephone_number": "515-276-1212",
            "fax_number": "515-276-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVELDEN",
        "first_name": "MARC",
        "middle_name": "LEE",
        "credential": "DPT CSCS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2012-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03548",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND",
            "identifier": "37197",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GR & MADRID",
            "identifier": "37198",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AH",
            "identifier": "39199",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ben G Vance, PA
• Jill Vandenberg
• Rachel Nicole Vander Hart, DPT
• Claire Vander Kooi
• Robert Vanderlinden Jr., DPT
• Brittany Jaron Vandevender
• Jennifer A Vandivier, P.A.-C.
• Irum Ibrahim Vedachhia, DDS
• Angela J Veenstra, ARNP
• Nicholas Gene Vellema, PA-C

• Physical Therapist in West Des Moines, IA
• Providers in West Des Moines, IA by specialty
• Physical Therapist in Iowa

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