Active NPI
Mary Elizabeth Vandeven, DPT
- Physical Therapist
- Draper, UT
National Provider Identifier
1003343260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PLL.0016925
- Practice address
- 13937 S Sprague LN Ste 100
Draper, UT 84020-7864 - Phone
- (385) 308-8034
- NPI assigned
- May 18, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 15
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT39443 | FL | |
| Physical Therapist | 225100000X | PT6402 | ME | |
| Physical Therapist | 225100000X | PTH11154 | AL | |
| Physical Therapist | 225100000X | 070.027215 | IL | |
| Physical Therapist | 225100000X | 1373888 | TX | |
| Physical Therapist | 225100000X | 05014994A | IN | |
| Physical Therapist | 225100000X | PT026407 | PA | |
| Physical Therapist | 225100000X | 11-07291 | KS | |
| Physical Therapist | 225100000X | PT03657 | RI | |
| Physical Therapist | 225100000X | 10033 | TN | |
| Physical Therapist | 225100000X | 050472 | NY | |
| Physical Therapist | 225100000X | 304318 | CA | |
| Physical Therapist | 225100000X | PT-2324 | WY | |
| Physical Therapist | 225100000X | PT020768 | OH | |
| Physical Therapist | 225100000X | PLL.0016925 | CO | Primary |
Addresses
Primary practice location
13937 S Sprague LN Ste 100
Draper, UT 84020-7864
Mailing address
212 E Columbia St
Colorado Springs, CO 80907-7425
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 |
|---|---|---|---|
| 10033 | TN | MD | Dental Hygienist |
| PTH11154 | AL | MD | Physical Therapist |
| 304318 | CA | MD | Physical Therapist |
| PLL.0016925 | CO | MD | Physical Therapist |
| PT39443 | FL | MD | Physical Therapist |
| 070.027215 | IL | MD | Physical Therapist |
| 05014994A | IN | MD | Physical Therapist |
| 11-07291 | KS | MD | Physical Therapist |
| PT6402 | ME | MD | Physical Therapist |
| 050472 | NY | MD | Physical Therapist |
| PT020768 | OH | MD | Physical Therapist |
| PT026407 | PA | MD | Physical Therapist |
| PT03657 | RI | MD | Physical Therapist |
| 1373888 | TX | MD | Physical Therapist |
| PT-2324 | WY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1495065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724630400000",
"number": "1003343260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 E COLUMBIA ST",
"city": "COLORADO SPRINGS",
"state": "CO",
"postal_code": "809077425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13937 S SPRAGUE LN STE 100",
"city": "DRAPER",
"state": "UT",
"postal_code": "840207864",
"telephone_number": "385-308-8034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDEVEN",
"first_name": "MARY",
"middle_name": "ELIZABETH",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-05-18",
"last_updated": "2024-08-26",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT39443",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "ME",
"license": "PT6402",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH11154",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070.027215",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1373888",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IN",
"license": "05014994A",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT026407",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-07291",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "RI",
"license": "PT03657",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "10033",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "050472",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "304318",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WY",
"license": "PT-2324",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "PT020768",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PLL.0016925",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Draper, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.