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
- Last updated
- Jun 11, 2020
- 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 |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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.