Individual provider Active NPI

Vanessa Ploederl, COTA

  • Occupational Therapy Assistant
  • Green Bay, WI
National Provider Identifier
1033386404
Registry record updated Mar 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4591-027 Issued in WI
Practice address
1040 Pilgrim Way
Green Bay, WI 54304-5028
Phone
(920) 405-3522
Fax
(920) 405-3523
NPI assigned
May 14, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 4591-027 WI Primary

Addresses

Primary practice location

1040 Pilgrim Way
Green Bay, WI 54304-5028

Mailing address

1040 Pilgrim Way
Green Bay, WI 54304-5028
Phone (920) 405-3522

Other names 1

  • Miss Vanessa Francl Former name

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

LicenseStateTypeSpecialty
4591-027WIMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330992000000",
    "number": "1033386404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 PILGRIM WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045028",
            "telephone_number": "920-405-3522",
            "fax_number": "920-405-3523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 PILGRIM WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543045028",
            "telephone_number": "920-405-3522",
            "fax_number": "920-405-3523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOEDERL",
        "first_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2012-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "4591-027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VANESSA",
            "last_name": "FRANCL",
            "prefix": "MISS",
            "credential": "COTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2012; 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.