Tara Rae Vancleave

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

Practice address

5310 South Broadway Circle
Building 6 Appt 306
Englewood, CO 80113

Phone

(303) 886-8198

NPI assigned

Nov 21, 2022

Last updated

Nov 21, 2022By the provider in NPPES

Sex

Female

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

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1356050215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 S BROADWAY CIR APT 6-306",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "801136851",
            "telephone_number": "303-886-8198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 SOUTH BROADWAY CIRCLE",
            "address_2": "BUILDING 6 APPT 306",
            "city": "ENGLEWOOD",
            "state": "CO",
            "postal_code": "80113",
            "telephone_number": "303-886-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCLEAVE",
        "first_name": "TARA",
        "middle_name": "RAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Physical Therapist in Englewood, CO
• Providers in Englewood, CO by specialty
• Pediatric Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.