Active NPI
Van Lanzendorfer, PTA
- Physical Therapy Assistant
- Bellevile, PA
National Provider Identifier
1508321928
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TEO11978
- Practice address
- 4202 E Main St
Bellevile, PA 17004 - Phone
- (717) 935-2105
- NPI assigned
- Feb 11, 2019
- Last updated
- Feb 11, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | TEO11978 | PA | Primary |
Addresses
Primary practice location
4202 E Main St
Bellevile, PA 17004
Mailing address
16832 Dunnings Hwy
Duncansville, PA 16635-4631
Phone (814) 330-3976
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
| License | State | Type | Specialty |
|---|---|---|---|
| TEO11978 | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549843200000",
"number": "1508321928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16832 DUNNINGS HWY",
"city": "DUNCANSVILLE",
"state": "PA",
"postal_code": "166354631",
"telephone_number": "814-330-3976"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4202 E MAIN ST",
"city": "BELLEVILE",
"state": "PA",
"postal_code": "17004",
"telephone_number": "717-935-2105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANZENDORFER",
"first_name": "VAN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-11",
"last_updated": "2019-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TEO11978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.