Active NPI
Victoria Van Dame, OTR/L
- Occupational Therapist
- Albuquerque, NM
National Provider Identifier
1043357569
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1781
- Practice address
- 709 Central Ave NW
Albuquerque, NM 87102-3007 - Phone
- (505) 249-2231
- Fax
- (505) 212-0605
- NPI assigned
- Jan 31, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1781 | NM | Primary |
Addresses
Primary practice location
709 Central Ave NW
Albuquerque, NM 87102-3007
Mailing address
709 Central Ave NW
P O Box 2779
Albuquerque, NM 87102-3007
Phone (505) 249-2231
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1781 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591833600000",
"number": "1043357569",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 CENTRAL AVE NW",
"address_2": "P O BOX 2779",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023007",
"telephone_number": "505-249-2231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 CENTRAL AVE NW",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871023007",
"telephone_number": "505-249-2231",
"fax_number": "505-212-0605"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN DAME",
"first_name": "VICTORIA",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-31",
"last_updated": "2020-06-11",
"certification_date": "2020-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "1781",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.