Individual provider Active NPI

Victoria Ann Walters, MSOT, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Hastings on Hudson, NY
National Provider Identifier
1124660493
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
46TR00903200 Issued in NJ
Practice address
185 Old Broadway
Hastings on Hudson, NY 10706-3801
Phone
(914) 478-3700
NPI assigned
Oct 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 024088 NY
Pediatric Occupational Therapist 225XP0200X 024088 NY
Physical Rehabilitation Occupational Therapist 225XP0019X 46TR00903200 NJ Primary

Addresses

Primary practice location

185 Old Broadway
Hastings on Hudson, NY 10706-3801

Mailing address

129 Parkside Dr
Suffern, NY 10901-7839

Other identifiers 1

IdentifierTypeStateIssuer
46TR00903200OtherNJNJ OFFICE OF CONSUMER AFFAIRS

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
024088NYMDClinical Psychologist
46TR00903200NJMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1124660493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 PARKSIDE DR",
            "city": "SUFFERN",
            "state": "NY",
            "postal_code": "109017839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 OLD BROADWAY",
            "city": "HASTINGS ON HUDSON",
            "state": "NY",
            "postal_code": "107063801",
            "telephone_number": "914-478-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "VICTORIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NY",
            "license": "024088",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "024088",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NJ",
            "license": "46TR00903200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ OFFICE OF CONSUMER AFFAIRS",
            "identifier": "46TR00903200",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hastings on Hudson, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.