Envision Independence Rehab Services LLC

Primary specialty

Low Vision Occupational TherapistTaxonomy code 225XL0004X

Legal business name

ENVISION INDEPENDENCE REHAB SERVICES LLC

Practice address

108 Buttercup Dr
Cranberry TWP, PA 16066-6314

Phone

(724) 900-4633

NPI assigned

Sep 2, 2021

Last updated

Sep 2, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Georgiann Dieteman, OTNPI 1487794483

Title

Owner and Director

Phone

(724) 900-4633

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Georgiann Lynn Dieteman, OTRL

  • Occupational Therapist
  • Elma, NY
  • NPI 1487794483

  PA

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630540800000",
    "number": "1124796222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 BUTTERCUP DR",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160666314",
            "telephone_number": "724-900-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 BUTTERCUP DR",
            "city": "CRANBERRY TWP",
            "state": "PA",
            "postal_code": "160666314",
            "telephone_number": "724-900-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENVISION INDEPENDENCE REHAB SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A",
        "authorized_official_last_name": "DIETEMAN",
        "authorized_official_first_name": "GEORGIANN",
        "authorized_official_title_or_position": "OWNER AND DIRECTOR",
        "authorized_official_telephone_number": "724-900-4633",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Cranberry TWP, PA
• Providers in Cranberry TWP, PA by specialty
• Occupational Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.