Jean Marie Vandermarliere, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

402-019 Issued in WI

Practice address

1629 E Division St
River Falls, WI 54022-1571

Phone

(715) 426-4537

Fax

(715) 426-4602

NPI assigned

Jan 2, 2007

Sex

Female

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jvandermarliere12074@excellian.direct.allina.com

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982761987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W5164 COUNTY ROAD G",
            "city": "BELDENVILLE",
            "state": "WI",
            "postal_code": "540035103",
            "telephone_number": "715-273-3891",
            "fax_number": "715-426-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 E DIVISION ST",
            "city": "RIVER FALLS",
            "state": "WI",
            "postal_code": "540221571",
            "telephone_number": "715-426-4537",
            "fax_number": "715-426-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERMARLIERE",
        "first_name": "JEAN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "402-019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "36106100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Unbridled Abilities, LLC.
• University of Wisconsin System Non Payroll
• University of Wisconsin System Non Payroll
• Anne Utyro
• Valley Anesthesia, LTD
• Mary Jo Veenendall, M.S. CCC-SLP
• Jeanna L Viramontes, PT
• Walgreen Co
• Mary M Walker
• Heidi Marie Webb, DC

• Physical Therapy Assistant in River Falls, WI
• Providers in River Falls, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.