Active NPI
Joel Eric Vanderlugt, P.T. , D.P.T.
- Physical Therapist
- Caledonia, MI
National Provider Identifier
1992089858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT-2859
- Practice address
- 9028 N Rodgers Dr
Suite J
Caledonia, MI 49316 - Phone
- (616) 891-0600
- Fax
- (208) 489-4300
- NPI assigned
- Oct 10, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT-2859 | ID | Primary |
Addresses
Primary practice location
9028 N Rodgers Dr
Suite J
Caledonia, MI 49316
Mailing address
PO Box 30516
Dept 5300
Lansing, MI 48909
Phone (616) 340-1643
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT-2859 | ID | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695168000000",
"number": "1992089858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30516",
"address_2": "DEPT 5300",
"city": "LANSING",
"state": "MI",
"postal_code": "48909",
"telephone_number": "616-340-1643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9028 N RODGERS DR",
"address_2": "SUITE J",
"city": "CALEDONIA",
"state": "MI",
"postal_code": "49316",
"telephone_number": "616-891-0600",
"fax_number": "208-489-4300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDERLUGT",
"first_name": "JOEL",
"middle_name": "ERIC",
"name_prefix": "Mr.",
"credential": "P.T. , D.P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-10",
"last_updated": "2023-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ID",
"license": "PT-2859",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caledonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.