Active NPI
Margo M Vivlamore, COTA
- Occupational Therapy Assistant
- Malone, NY
National Provider Identifier
1093024382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 64005130
- Practice address
- 99 Elm St
St Josephs Elementary
Malone, NY 12953-1519 - Phone
- (518) 483-7806
- NPI assigned
- Oct 4, 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 | 64005130 | NY | Primary |
Addresses
Primary practice location
99 Elm St
St Josephs Elementary
Malone, NY 12953-1519
Mailing address
4 Island St PO Box 95
Norfolk, NY 13667
Phone (518) 483-7806
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64005130 | Other | NY | NYS |
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 |
|---|---|---|---|
| 64005130 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286150400000",
"number": "1093024382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 ISLAND ST PO BOX 95",
"city": "NORFOLK",
"state": "NY",
"postal_code": "13667",
"telephone_number": "518-483-7806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 ELM ST",
"address_2": "ST JOSEPHS ELEMENTARY",
"city": "MALONE",
"state": "NY",
"postal_code": "129531519",
"telephone_number": "518-483-7806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VIVLAMORE",
"first_name": "MARGO",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-04",
"last_updated": "2010-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "64005130",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NYS",
"identifier": "64005130",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Malone, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.