Active NPI
Vicki L Bennett, OTR/L
- Occupational Therapist
- Las Cruces, NM
National Provider Identifier
1033373154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT3165
- Practice address
- 1005 Lujan Hill Rd
Las Cruces, NM 88007-6304 - Phone
- (575) 523-4573
- NPI assigned
- Jul 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT3165 | NM | Primary |
| Occupational Therapist | 225X00000X | OT1229 | ME |
Addresses
Primary practice location
1005 Lujan Hill Rd
Las Cruces, NM 88007-6304
Mailing address
137 High St
West Paris, ME 04289-5200
Phone (207) 595-8211
Other practice location 1
322 N Gorham Rd
Gorham, ME 04038-2422
Phone (207) 595-8211
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT1229 | ME | MD | Occupational Therapist |
| OT3165 | NM | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641772800000",
"number": "1033373154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "137 HIGH ST",
"city": "WEST PARIS",
"state": "ME",
"postal_code": "042895200",
"telephone_number": "207-595-8211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 LUJAN HILL RD",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880076304",
"telephone_number": "575-523-4573"
}
],
"practiceLocations": [
{
"address_1": "322 N Gorham Rd",
"address_purpose": "LOCATION",
"city": "Gorham",
"state": "ME",
"postal_code": "040382422",
"country_code": "US",
"telephone_number": "207-595-8211",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BENNETT",
"first_name": "VICKI",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-07-17",
"last_updated": "2022-01-10",
"certification_date": "2022-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "OT3165",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ME",
"license": "OT1229",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.