Vastina Denise Mayes

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

A08149 Issued in MD

Practice address

5712 Rolland Ave 2D
Balt, MD 21210

Phone

(443) 514-5775

NPI assigned

Feb 22, 2023

Last updated

Feb 22, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1677024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1184322786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5712 ROLLAND AVE 2D",
            "city": "BALT",
            "state": "MD",
            "postal_code": "21210",
            "telephone_number": "443-514-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5712 ROLLAND AVE 2D",
            "city": "BALT",
            "state": "MD",
            "postal_code": "21210",
            "telephone_number": "443-514-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYES",
        "first_name": "VASTINA",
        "middle_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-22",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MD",
            "license": "A08149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lillian Anne Cooperman, MAC LAC DIPL AC
• Kelley Miller, SLP
• Roy Ruehle, PAC OGTSUCUABS ASSIS
• Howard Kenneth Wagenheim, LPT LICENSED PHYSICA
• Cynthia B Wiley, MS PA C

• Occupational Therapy Assistant in Balt, MD
• Providers in Balt, MD by specialty
• Occupational Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2023; 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.