Derek Vraa, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

0015495 Issued in CO

Practice address

10 MDG 4102 Pinion Dr
Usaf Academy, CO 80840-2502

Phone

(719) 333-3107

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1780763219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4102 PINION DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MDG 4102 PINION DR",
            "city": "USAF ACADEMY",
            "state": "CO",
            "postal_code": "808402502",
            "telephone_number": "719-333-3107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VRAA",
        "first_name": "DEREK",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "6382",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0015495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "940560700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linh Thuy Truong, DMD
• Usafa
• Stacey Alicia Vandyke, CRNA
• Bethany Vawter
• Jamie Virden, PHYSICIAN ASSISTANT
• John Wesley Waggoner, PSY.D.
• Mary Claire Wahl, C.N.M.
• David J Walick, M.D.
• Bianca Bautista Walker-Gundolff, AT. ATC
• Timothy James Walker, MD

• Physical Therapist in Usaf Academy, CO
• Providers in Usaf Academy, CO by specialty
• Physical Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.