Lawrence Joseph Vanty Jr., PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-953 Issued in ID

Practice address

2315 8TH St
Lewiston, ID 83501-7301

Phone

(208) 298-3094

Fax

(833) 941-3874

NPI assigned

Dec 7, 2011

Last updated

Dec 10, 2024By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ID

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Catalyst Medical Group, PLLC

  • Multi-Specialty Clinic/Center
  • Lewiston, ID
  • NPI 1912458787
  Medicare reassignment
• Idaho Emergency Physicians, P.a.

  • Emergency Medicine Physician
  • Meridian, ID
  • NPI 1730133208
  NPD (past)

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

{
    "created_epoch": "1323216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1609144435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 8TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835017301",
            "telephone_number": "208-298-3094",
            "fax_number": "833-941-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 8TH ST",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835017301",
            "telephone_number": "208-298-3094",
            "fax_number": "833-941-3874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 Warner Dr",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835014441",
            "country_code": "US",
            "telephone_number": "208-298-3094",
            "fax_number": "833-941-3874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANTY",
        "first_name": "LAWRENCE",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-07",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ID",
            "license": "PA-953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609144435",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valley Medical Center, PLLC
• Valley Radiation PLLC
• Valley Treatment Specialties LLC
• Josephine Van Kampen-Lewis, LCSW
• Vannvei LLC
• Vault Physical Therapy LLC
• Laura Beth Vervain
• Joanne Vestal, PHARMD
• Jennifer Vigeant, LPN
• Darla Kay Villopoto, LMT

• Medical Physician Assistant in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Medical Physician Assistant in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.