Individual provider Active NPI

Annette L Fielder, OTR/L

  • Occupational Therapist
  • Blacksburg, VA
National Provider Identifier
1174710768
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119002158 Issued in VA
Practice address
706 Coal Bank Hollow Rd
Blacksburg, VA 24060-8622
Phone
(540) 553-6695
NPI assigned
Sep 27, 2007
Last updated
Aug 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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 0119002158 VA Primary

Addresses

Primary practice location

706 Coal Bank Hollow Rd
Blacksburg, VA 24060-8622

Mailing address

706 Coal Bank Hollow Rd
Blacksburg, VA 24060-8622
Phone (540) 553-6695

Other identifiers 2

IdentifierTypeStateIssuer
2128185OtherVAMAMSI
2450084OtherVAUNITED HEALTHCARE OF MID

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
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0119002158VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bath County Community Hospital Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346112000000",
    "number": "1174710768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 COAL BANK HOLLOW RD",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240608622",
            "telephone_number": "540-553-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 COAL BANK HOLLOW RD",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240608622",
            "telephone_number": "540-553-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDER",
        "first_name": "ANNETTE",
        "middle_name": "L",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-27",
        "last_updated": "2012-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119002158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2128185",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE OF MID",
            "identifier": "2450084",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blacksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.