Active NPI
Vanese Itangishaka
- Rehabilitation Practitioner
- Meridian, ID
National Provider Identifier
1902768401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Practitioner
- Practice address
- 3288 E Pine Ave Apt 211
Meridian, ID 83642-5922 - Phone
- (208) 888-8887
- NPI assigned
- Dec 2, 2025
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | ID | ||
| Rehabilitation Practitioner | 225400000X | ID | Primary |
Addresses
Primary practice location
3288 E Pine Ave Apt 211
Meridian, ID 83642-5922
Mailing address
3288 E Pine Ave Apt 211
Meridian, ID 83642-5922
Phone (208) 888-8887
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1764633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1764633600000",
"number": "1902768401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3288 E PINE AVE APT 211",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425922",
"telephone_number": "208-888-8887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3288 E PINE AVE APT 211",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836425922",
"telephone_number": "208-888-8887"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ITANGISHAKA",
"first_name": "VANESE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-12-02",
"last_updated": "2025-12-02",
"certification_date": "2025-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "ID",
"license": null,
"primary": false
},
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "ID",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.