Individual provider Active NPI

Kaochi Desjheannette Vang, MS OTR

  • Occupational Therapist
  • Oshkosh, WI
National Provider Identifier
1174990253
Registry record updated Nov 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5701-26 Issued in WI
Practice address
Aurora Medical Center of Oshkosh - Rehab
855 N. Westhaven Drive
Oshkosh, WI 54904
Phone
(920) 456-7395
Fax
(920) 456-7101
NPI assigned
Aug 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2018

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 5701-26 WI Primary

Addresses

Primary practice location

Aurora Medical Center of Oshkosh - Rehab
855 N. Westhaven Drive
Oshkosh, WI 54904

Mailing address

Aurora Medical Center of Oshkosh - Rehab
855 N. Westhaven Drive
Oshkosh, WI 54904
Phone (920) 456-7395

Other names 1

  • Mrs. Kaochi Desjheannette Her Former name

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
Master of Science

State licenses

LicenseStateTypeSpecialty
5701-26WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1440460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541635200000",
    "number": "1174990253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "AURORA MEDICAL CENTER OF OSHKOSH - REHAB",
            "address_2": "855 N. WESTHAVEN DRIVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54904",
            "telephone_number": "920-456-7395",
            "fax_number": "920-456-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "AURORA MEDICAL CENTER OF OSHKOSH - REHAB",
            "address_2": "855 N. WESTHAVEN DRIVE",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "54904",
            "telephone_number": "920-456-7395",
            "fax_number": "920-456-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANG",
        "first_name": "KAOCHI",
        "middle_name": "DESJHEANNETTE",
        "name_prefix": "Mrs.",
        "credential": "MS OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-25",
        "last_updated": "2018-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "5701-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAOCHI",
            "last_name": "HER",
            "middle_name": "DESJHEANNETTE",
            "prefix": "MRS.",
            "credential": "MS OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Oshkosh, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; 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.