Active NPI
Victoria Sue Head, COTA
- Occupational Therapy Assistant
- Sheboygan, WI
National Provider Identifier
1063724938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 430 - 027
- Practice address
- 3014 Erie Ave
Sheboygan, WI 53081-3658 - Phone
- (920) 459-3028
- NPI assigned
- Jul 8, 2010
- 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 Therapy Assistant | 224Z00000X | 430 - 027 | WI | Primary |
Addresses
Primary practice location
3014 Erie Ave
Sheboygan, WI 53081-3658
Mailing address
445 Grandview Cir
Adell, WI 53001-1164
Phone (920) 254-7209
Other names 1
- Ms. Victoria Sue Hoogland
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 |
|---|---|---|---|
| 430 - 027 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278547200000",
"number": "1063724938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "445 GRANDVIEW CIR",
"city": "ADELL",
"state": "WI",
"postal_code": "530011164",
"telephone_number": "920-254-7209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3014 ERIE AVE",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530813658",
"telephone_number": "920-459-3028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEAD",
"first_name": "VICTORIA",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-07-08",
"last_updated": "2010-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "430 - 027",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "VICTORIA",
"last_name": "HOOGLAND",
"middle_name": "SUE",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.