NPIMap

Individual provider Active NPI

Vickie Patricia Mullins, OTR / CHT

  • Hand Occupational Therapist
  • Manitowoc, WI
National Provider Identifier
1144330796
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
266-026 Issued in WI
Practice address
920 State St
Manitowoc, WI 54220-4038
Phone
(920) 683-1900
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ergonomics Occupational Therapist 225XE1200X 1051100444 WI
Hand Occupational Therapist 225XH1200X 266-026 WI Primary
Neurorehabilitation Occupational Therapist 225XN1300X 266-026 WI

Addresses

Primary practice location

920 State St
Manitowoc, WI 54220-4038

Mailing address

920 State St
Manitowoc, WI 54220-4038
Phone (920) 683-1900

Other identifiers 1

IdentifierTypeStateIssuer
40855800MedicaidWI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1051100444WIMDErgonomics Occupational Therapist
266-026WIMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Clinic LLP Past Accepting new patients
Orthopaedic Associates of Manitowoc LTD Past Accepting new patients
Aurora Health Care North, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1144330796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 STATE ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204038",
            "telephone_number": "920-683-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 STATE ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204038",
            "telephone_number": "920-683-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "VICKIE",
        "middle_name": "PATRICIA",
        "credential": "OTR / CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": "WI",
            "license": "1051100444",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "WI",
            "license": "266-026",
            "primary": true
        },
        {
            "code": "225XN1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Neurorehabilitation",
            "state": "WI",
            "license": "266-026",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40855800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2013; 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.