Individual provider Active NPI

Alyson Vanya, CPNP-PC

  • Pediatric Nurse Practitioner
  • Jasper, TX
National Provider Identifier
1275002230
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP139783 Issued in TX
Practice address
1008 Dickerson Dr
Jasper, TX 75951-5111
Phone
(409) 489-9322
NPI assigned
Nov 20, 2018
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP139783 TX Primary

Addresses

Primary practice location

1008 Dickerson Dr
Jasper, TX 75951-5111

Mailing address

1008 Dickerson Dr
Jasper, TX 75951-5111
Phone (409) 489-9322

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
AP139783TXMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1542672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1275002230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1008 DICKERSON DR",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759515111",
            "telephone_number": "409-489-9322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 DICKERSON DR",
            "city": "JASPER",
            "state": "TX",
            "postal_code": "759515111",
            "telephone_number": "409-489-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANYA",
        "first_name": "ALYSON",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-20",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP139783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jasper, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.