Brian Paul Royal Vanwyngarden, LMT

Primary specialty

ContractorTaxonomy code 171W00000X

License

21790 Issued in OR

Practice address

2416 13TH St SE
Salem, OR 97302-2546

Phone

(503) 798-2918

NPI assigned

Jul 28, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Salem Community Acupuncture Project

  • Clinic/Center
  • Salem, OR
  • NPI 1275983660
  NPD (past)

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

{
    "created_epoch": "1469664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469664000000",
    "number": "1124571823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 21ST ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973018848",
            "telephone_number": "612-638-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2416 13TH ST SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973022546",
            "telephone_number": "503-798-2918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWYNGARDEN",
        "first_name": "BRIAN",
        "middle_name": "PAUL ROYAL",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-28",
        "last_updated": "2016-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "OR",
            "license": "21790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean Thompson Vanlue, M.A., LPC, LMFT
• Sara Vanocker, LCSW, CADC III
• Erin F Vanortwick
• Carol L Vanschepen, N.P.
• Earl J Vanvolkinburg, MD
• Eva Vaquera-Contreras, BSN, RN
• Cindy Vargas Toledo
• Arturo Vargas, HRC
• Brenda Grizelda Vargas
• John M Vargo, D O

• Contractor in Salem, OR
• Providers in Salem, OR by specialty
• Contractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2016; 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.