Individual provider Active NPI

Andrew Vereen, MS, ATC, LAT, CES

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Des Moines, IA
National Provider Identifier
1609479229
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
License
074479 Issued in IA
Practice address
2601 Forest Dr
Des Moines, IA 50312-5411
Phone
(712) 490-9197
NPI assigned
Nov 17, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X 074479 IA Primary

Addresses

Primary practice location

2601 Forest Dr
Des Moines, IA 50312-5411

Mailing address

8704 Meredith Dr Apt 106
Urbandale, IA 50322-7292
Phone (712) 490-9197

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
074479IAMDSports Medicine (Physical Medicine & Rehabilitation) Physician

NPI Registry JSON

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

{
    "created_epoch": "1605571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1609479229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8704 MEREDITH DR APT 106",
            "city": "URBANDALE",
            "state": "IA",
            "postal_code": "503227292",
            "telephone_number": "712-490-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 FOREST DR",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503125411",
            "telephone_number": "712-490-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEREEN",
        "first_name": "ANDREW",
        "credential": "MS, ATC, LAT, CES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-17",
        "last_updated": "2020-11-17",
        "certification_date": "2020-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "IA",
            "license": "074479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2020; 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.