Individual provider Active NPI

David James Vanas, PT, DPT

  • Physical Therapist
  • Boulder, CO
National Provider Identifier
1235426321
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL-11337 Issued in CO
Practice address
802 19TH St
Boulder, CO 80302-7612
Phone
(440) 463-9267
NPI assigned
Jul 8, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL-11337 CO Primary

Addresses

Primary practice location

802 19TH St
Boulder, CO 80302-7612

Mailing address

2100 16TH St
Unit 212
Denver, CO 80202-5184
Phone (440) 463-9267

Other identifiers 1

IdentifierTypeStateIssuer
PTL-11337OtherCOLICENSE NUMBER

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

LicenseStateTypeSpecialty
PTL-11337COMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1235426321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 16TH ST",
            "address_2": "UNIT 212",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802025184",
            "telephone_number": "440-463-9267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 19TH ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803027612",
            "telephone_number": "440-463-9267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANAS",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-08",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL-11337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PTL-11337",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.