Ryan Edward Vandervest, MS, LAT, CSCS

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

626-039 Issued in WI

Practice address

760 Pilgrim Way
Green Bay, WI 54304-5263

Phone

(920) 496-4750

NPI assigned

Feb 17, 2006

Sex

Male

Sole proprietor

No

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1285609941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2840 CHAR LA MAR DR",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543116573",
            "telephone_number": "920-496-4750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 PILGRIM WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045263",
            "telephone_number": "920-496-4750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERVEST",
        "first_name": "RYAN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "MS, LAT, CSCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "626-039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Lynn Vanderlin, RN MSN APNP C
• Luke Vandermause, PHARMD
• Patricia L Vandermause, LPC ,CSAC
• Margaret Innis Vandermeer, PT
• Joseph Martin Vandersteen, CRNA APNP
• Pamela J Vanderwall, MD
• Amy S. Vanderwielen, RD,CD
• Sherwood W Vanderwoude, MD
• Stephanie Vandevelde, PTA
• Lisa Vandeven, PTA

• Athletic Trainer in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Athletic Trainer in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.