Active NPI
Melissa Vaught
- Occupational Therapist
- Virginia Beach, VA
National Provider Identifier
1043437296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0119004411
- Practice address
- 4560 South Blvd
310
Virginia Beach, VA 23452-1160 - Phone
- (757) 490-3223
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- No
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 | 0119004411 | VA | Primary |
Addresses
Primary practice location
4560 South Blvd
310
Virginia Beach, VA 23452-1160
Mailing address
635 Graydon Ave
Apt. 6
Norfolk, VA 23507-1737
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004979907 | Medicaid | VA |
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 |
|---|---|---|---|
| 0119004411 | VA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043437296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 GRAYDON AVE",
"address_2": "APT. 6",
"city": "NORFOLK",
"state": "VA",
"postal_code": "235071737"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4560 SOUTH BLVD",
"address_2": "310",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234521160",
"telephone_number": "757-490-3223"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAUGHT",
"first_name": "MELISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VA",
"license": "0119004411",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004979907",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.