Lauren Olivia Vangorp, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-6706 Issued in ID

Practice address

5418 N Eagle Rd Ste 170
Boise, ID 83713-0999

Phone

(208) 501-8264

Fax

(208) 514-1558

NPI assigned

Jun 8, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1811512650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8048 WATERCRESS AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836878289",
            "telephone_number": "219-713-2486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5418 N EAGLE RD STE 170",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837130999",
            "telephone_number": "208-501-8264",
            "fax_number": "208-514-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANGORP",
        "first_name": "LAUREN",
        "middle_name": "OLIVIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-6706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dane Vander Wall, ND
• Derek Daniel Vanderburg, PA-C
• Melanie Vanderpol, AUD
• Patricia Vandervelden, SPEECH THERAPIST
• Kaitlyn Marie Vandyk, LMSW
• Tonja Vanhees, PT
• Amber Vania, DO
• Carolina M. Vania, OTLP
• Cyrus H Vania, DO
• Shane Daniel Vania, DDS

• Physical Therapist in Boise, ID
• Providers in Boise, ID by specialty
• Physical Therapist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.