Active NPI
Teaira Faithangel Vangaalen, PTA
- Physical Therapy Assistant
- Glendale, AZ
National Provider Identifier
1558838508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 13842
- Practice address
- 8811 N 51St Ave Ste 102
Glendale, AZ 85302-4949 - Phone
- (623) 915-2726
- NPI assigned
- Oct 29, 2018
- Sex
- Female
- 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 | 13842 | AZ | Primary |
Addresses
Primary practice location
8811 N 51St Ave Ste 102
Glendale, AZ 85302-4949
Mailing address
3050 N Litchfield Rd Ste 100
Goodyear, AZ 85395-7805
Phone (602) 588-0320
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 013842 | Other | AZ | LICENSE |
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 |
|---|---|---|---|
| 13842 | AZ | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1540771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540771200000",
"number": "1558838508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3050 N LITCHFIELD RD STE 100",
"city": "GOODYEAR",
"state": "AZ",
"postal_code": "853957805",
"telephone_number": "602-588-0320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8811 N 51ST AVE STE 102",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853024949",
"telephone_number": "623-915-2726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANGAALEN",
"first_name": "TEAIRA",
"middle_name": "FAITHANGEL",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-29",
"last_updated": "2018-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "AZ",
"license": "13842",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "013842",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Glendale, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.