Lacy Lin Vadder, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

844 Issued in OK

Practice address

1679 N 2780 Rd
Hennessey, OK 73742-6624

Phone

(405) 853-1210

NPI assigned

Jul 17, 2013

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 17, 2013.

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374019200000",
    "number": "1194166264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1679 N 2780 RD",
            "city": "HENNESSEY",
            "state": "OK",
            "postal_code": "737426624",
            "telephone_number": "405-853-1210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1679 N 2780 RD",
            "city": "HENNESSEY",
            "state": "OK",
            "postal_code": "737426624",
            "telephone_number": "405-853-1210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VADDER",
        "first_name": "LACY",
        "middle_name": "LIN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2013-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelley Larae Rauh-Galusha, APRN
• Dale D. Reinschmiedt, D.O.
• Kelli L Schenk, RD/LD
• Tabatha J Scott, MED CCC SLP
• John O. Smith, O.D.

• All providers in Hennessey, OK
• Occupational Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.