Individual provider Active NPI

Paul W Vantol, N.P.

  • Family Nurse Practitioner
  • Lafayette, CO
National Provider Identifier
1962557934
Registry record updated Mar 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
130021 Issued in CO
Practice address
2593 Park LN
Lafayette, CO 80026-3172
Phone
(303) 665-0115
Fax
(303) 415-3470
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 130021 CO Primary

Addresses

Primary practice location

2593 Park LN
Lafayette, CO 80026-3172

Mailing address

2104 Amber CT
Erie, CO 80516-6833
Phone (303) 915-8769

Other practice location 1

309 US Highway 287
Lafayette, CO 80026-8885
Phone (303) 665-2497

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
130021COMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tru Community Care PastSince Apr 5, 2020 Accepting new patients
Health Stop LLC 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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1962557934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 AMBER CT",
            "city": "ERIE",
            "state": "CO",
            "postal_code": "805166833",
            "telephone_number": "303-915-8769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2593 PARK LN",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263172",
            "telephone_number": "303-665-0115",
            "fax_number": "303-415-3470"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 US Highway 287",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "CO",
            "postal_code": "800268885",
            "country_code": "US",
            "telephone_number": "303-665-2497",
            "fax_number": "303-665-2528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANTOL",
        "first_name": "PAUL",
        "middle_name": "W",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "130021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; 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.