Individual provider Active NPI

Anna Vancamp, PTA

  • Physical Therapy Assistant
  • Canon City, CO
National Provider Identifier
1003502162
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
Practice address
722 S 8TH St
Canon City, CO 81212-4906
Phone
(719) 345-4097
Fax
(719) 249-1516
NPI assigned
Apr 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 0015239 CO
Physical Therapy Assistant 225200000X Primary

Addresses

Primary practice location

722 S 8TH St
Canon City, CO 81212-4906

Mailing address

722 S 8TH St
Canon City, CO 81212-4906
Phone (719) 345-4097

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0015239COMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The Hudson Group Inc. CurrentSince Apr 16, 2023 Accepting new patients

Locations

722 S 8th St
Canon City, CO 81212
Phone (719) 345-4097

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1003502162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 S 8TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124906",
            "telephone_number": "719-345-4097",
            "fax_number": "719-249-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 S 8TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124906",
            "telephone_number": "719-345-4097",
            "fax_number": "719-249-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCAMP",
        "first_name": "ANNA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "0015239",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.

Verify at the official NPI Registry.