Individual provider Active NPI

Viviene Anderson

  • Occupational Therapist
  • Valley Stream, NY
National Provider Identifier
1154632073
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
007684-1 Issued in NY
Practice address
192 Dogwood Rd
Valley Stream, NY 11580-4002
Phone
(516) 561-2109
NPI assigned
Jun 25, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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 007684-1 NY Primary

Addresses

Primary practice location

192 Dogwood Rd
Valley Stream, NY 11580-4002

Mailing address

192 Dogwood Rd
Valley Stream, NY 11580-4002
Phone (516) 561-2109

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
007684-1NYMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1154632073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 DOGWOOD RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804002",
            "telephone_number": "516-561-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "192 DOGWOOD RD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115804002",
            "telephone_number": "516-561-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "VIVIENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "007684-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; 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.