Mary Vanorden, CPT

Primary specialty

Respiratory/Developmental/Rehabilitative Specialist/TechnologistTaxonomy code 225500000X

License

T178488 Issued in ID

Practice address

1246 Yellowstone Ave Ste F2
Pocatello, ID 83201-4372

Phone

(208) 904-1270

Fax

(208) 904-1270

NPI assigned

Sep 5, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Mary Klassen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1409875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409875200000",
    "number": "1356742613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1246 YELLOWSTONE AVE STE F2",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014372",
            "telephone_number": "208-904-1270",
            "fax_number": "208-904-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1246 YELLOWSTONE AVE STE F2",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014372",
            "telephone_number": "208-904-1270",
            "fax_number": "208-904-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANORDEN",
        "first_name": "MARY",
        "credential": "CPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-05",
        "last_updated": "2014-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PTA-368",
            "primary": false
        },
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "ID",
            "license": "T178488",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "KLASSEN",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bailey Elizabeth Vanderwall
• David Vance Vanek, M.D.
• Kathleen Vanek, LPC
• Bryant Vanleeuwen, MD
• Curtis Zane Vanorden, PHARMD
• Julia Marie Vanosdol
• Ashley Vargas, LPC
• Rebecca L Vasas, OT
• Julio Cesar Vasquez, M.D.
• Peyton Vasquez

• Respiratory/Developmental/Rehabilitative Specialist/Technologist in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Respiratory/Developmental/Rehabilitative Specialist/Technologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; 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.