Individual provider Active NPI

Tawana Melissa Fischer, OTR/L, ATP

  • Occupational Therapist
  • Woodbridge, NJ
National Provider Identifier
1104061035
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
012874 Issued in NY
Practice address
81 Hillside Avenue
Woodbridge, NJ 07095-3611
Phone
(732) 423-4339
NPI assigned
Dec 5, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 012874 NY Primary
Occupational Therapist 225X00000X 46TR00436100 NJ

Addresses

Primary practice location

81 Hillside Avenue
Woodbridge, NJ 07095-3611

Mailing address

81 Hillside Avenue
Woodbridge, NJ 07095-3611
Phone (732) 423-4339

Other identifiers 2

IdentifierTypeStateIssuer
012874OtherNYNEW YORK STATE EDUCATION DEPARTMENT OCCUPATIONAL THERAPY LICENSE
46TR00436100OtherNJNEW JERSEY OFFICE OF ATTORNEY GENERAL DIVISION OF CONSUMER AFFAIRS OT ADV COUNCI

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

LicenseStateTypeSpecialty
012874NYMDChiropractor
46TR00436100NJMDOccupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1228435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228435200000",
    "number": "1104061035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HILLSIDE AVENUE",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070953611",
            "telephone_number": "732-423-4339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HILLSIDE AVENUE",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070953611",
            "telephone_number": "732-423-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "TAWANA",
        "middle_name": "MELISSA",
        "credential": "OTR/L, ATP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-05",
        "last_updated": "2008-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "012874",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NJ",
            "license": "46TR00436100",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE EDUCATION DEPARTMENT OCCUPATIONAL THERAPY LICENSE",
            "identifier": "012874",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW JERSEY OFFICE OF ATTORNEY GENERAL DIVISION OF CONSUMER AFFAIRS OT ADV COUNCI",
            "identifier": "46TR00436100",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.