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

Mr. Ryan Edward Vandervest, MS, LAT, CSCS

Individual provider Athletic Trainer · NPI 1285609941

Mr. Ryan Edward Vandervest, MS, LAT, CSCS is an Athletic Trainer in Green Bay, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2006.

Licensed in
WI
In the registry since
2006
What do these letters mean?
MS — Master of Science
A graduate science degree.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

760 Pilgrim Way
Green Bay, WI 54304-5263
Phone: (920) 496-4750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 626-039 (WI)

Record details

NPI number1285609941
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , LAT , CSCS
Sole proprietorNo
NPI enumeratedFebruary 17, 2006
Last updated in NPPESJuly 13, 2026
Mailing address2840 Char La Mar Dr, Green Bay, WI 54311-6573

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