Active NPI
Ann Malloy Vance, PA
- Physician Assistant
- Twin Falls, ID
National Provider Identifier
1902340987
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1504
- Practice address
- 200 2ND Ave N
Twin Falls, ID 83301-6158 - Phone
- (800) 769-0045
- NPI assigned
- Dec 11, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 54086 | CA | |
| Physician Assistant | 363A00000X | 1504 | ID | Primary |
Addresses
Primary practice location
200 2ND Ave N
Twin Falls, ID 83301-6158
Mailing address
PO Box 24547
Seattle, WA 98124-0547
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54086 | CA | MD | Periodontist |
| 1504 | ID | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky | Physician Assistant | Past | Accepting new patients |
| Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky | Physician Assistant | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Non-Surgical Family Planning Clinic/Center
- Seattle, WA
- NPI 1083700686
Physician Assistant
-
dba Planned Parenthood of Indiana and Kentucky
- Non-Surgical Family Planning Clinic/Center
- Indianapolis, IN
- NPI 1891743092
Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1481414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1902340987",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 24547",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981240547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 2ND AVE N",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833016158",
"telephone_number": "800-769-0045"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANCE",
"first_name": "ANN",
"middle_name": "MALLOY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-12-11",
"last_updated": "2021-12-14",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "54086",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "ID",
"license": "1504",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.