Johanna L. Vidola

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

110580 Issued in TX

Practice address

4647 Medical Dr
San Antonio, TX 78229-4403

Phone

(210) 358-2710

Fax

(210) 358-4738

NPI assigned

Mar 30, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pain Management Specialists

  • Interventional Pain Medicine Physician
  • San Antonio, TX
  • NPI 1922617125
  NPD (past)

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1432684800000",
    "number": "1013250877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 87",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782910087",
            "telephone_number": "210-358-9172",
            "fax_number": "210-358-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4647 MEDICAL DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294403",
            "telephone_number": "210-358-2710",
            "fax_number": "210-358-4738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDOLA",
        "first_name": "JOHANNA",
        "middle_name": "L.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-30",
        "last_updated": "2015-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "110580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elisa G Vidaurri, P.T.
• Marco Vidaurri Jr., PHARMD
• Vidavitale Concierge Nursing LLC
• Naema Kalifa Vides, SLP
• Yehefri Vides, CSFA
• Christine Vidouria, DO
• Candice Marie Vieira
• Vielka E Johnson
• Lorena Vielmann, LMSW
• Matthew Joseph Vierra, D.D.S.

• Occupational Therapist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2015; 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.