Derek Edward Vanous, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

304588 Issued in CA

Practice address

2724 Soquel Ave Ste B
Santa Cruz, CA 95062-1434

Phone

(831) 475-2565

NPI assigned

Aug 10, 2023

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

State licenses

Practice roles

Locations

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.

• Dewitt Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Santa Cruz, CA
  • NPI 1902198765

  Physical Therapist

  NPD
• Stoked Physio

  • Physical Therapy Clinic/Center
  • Santa Cruz, CA
  • NPI 1437971215
  NPD

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1316620800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18410 MCCLELLAN CIR",
            "city": "EAST GARRISON",
            "state": "CA",
            "postal_code": "939334967",
            "telephone_number": "785-955-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 SOQUEL AVE STE B",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621434",
            "telephone_number": "831-475-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANOUS",
        "first_name": "DEREK",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "304588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Vandenberg, FNP
• Melanie Rose Vandenberg, DMD
• Christina Mary Vandyke, RN
• Vanessa Hemingway, Otr LLC
• Dianna Marie Vaneycke
• Marga Vaquer-Rhodes, M.A., MFT
• Michelle Varady, MSW, LCSW
• Laura Varela
• Nalia Alexis Varela
• Angela Winston Vargas, CNM

• All providers in Santa Cruz, CA
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 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.