Jason James Vance, PT, DPT, COMT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

070.020056 Issued in IL

Practice address

1400 Midtown Rd
Peru, IL 61354-1269

Phone

(815) 223-8600

NPI assigned

Mar 16, 2020

Sex

Male

Sole proprietor

No

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

• St. Margaret'S Hospital

  • Rural Health Clinic/Center
  • Granville, IL
  • NPI 1497318299
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 16, 2020.

{
    "created_epoch": "1584316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584316800000",
    "number": "1619503265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 MIDTOWN RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541269",
            "telephone_number": "815-223-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 MIDTOWN RD",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541269",
            "telephone_number": "815-223-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "JASON",
        "middle_name": "JAMES",
        "credential": "PT, DPT, COMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-16",
        "last_updated": "2020-03-16",
        "certification_date": "2020-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070.020056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Beth Urbanski, RPH
• James Vaiana, DDS
• Valley Health Enterprise
• Valley Health Enterprises, Inc.
• Valley Regional Health Services L3C
• Michelle Vasquez, MD
• Vep Il Optometric LLC
• Angela Marie Vezzetti, PA-C
• Vitas Healthcare Corporation of Illinois
• Walgreen Co

• All providers in Peru, IL
• Physical Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.