Individual provider Active NPI

Amy Van Otterloo, OTR/L

  • Occupational Therapist
  • Dubuque, IA
National Provider Identifier
1104644848
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
4005 Westmark Dr Ste 320
Dubuque, IA 52002-2271
Phone
(563) 583-6977
NPI assigned
Oct 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X Primary

Addresses

Primary practice location

4005 Westmark Dr Ste 320
Dubuque, IA 52002-2271

Mailing address

350 N Grandview Ave
Dubuque, IA 52001-6388

Other practice location 1

350 N Grandview Ave
Dubuque, IA 52001-6388
Phone (563) 583-6977

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

NPI Registry JSON

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

{
    "created_epoch": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1104644848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N GRANDVIEW AVE",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520016388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 WESTMARK DR STE 320",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520022271",
            "telephone_number": "563-583-6977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 N Grandview Ave",
            "address_purpose": "LOCATION",
            "city": "Dubuque",
            "state": "IA",
            "postal_code": "520016388",
            "country_code": "US",
            "telephone_number": "563-583-6977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN OTTERLOO",
        "first_name": "AMY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-01",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.