Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Derek Vanderroest, PTA

Individual provider Physical Therapy Assistant · NPI 1720395023

Derek Vanderroest, PTA is a Physical Therapy Assistant in Prescott, Arizona. Licensed in Arizona. Registered with an NPI since 2010.

Licensed in
AZ
In the registry since
2010
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

3117 Stillwater Dr
Prescott, AZ 86305-7164
Phone: (928) 442-0005
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 9028A (AZ)

Record details

NPI number1720395023
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedSeptember 8, 2010
Last updated in NPPESSeptember 8, 2010
Mailing address3117 Stillwater Dr, Prescott, AZ 86305-7164

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