Individual provider Active NPI

Vivian Margareth Hennings, COTA

  • Occupational Therapy Assistant
  • Lakeland, FL
National Provider Identifier
1235859802
Registry record updated Sep 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
13389 Issued in FL
Practice address
5939 Buck Run Dr
Lakeland, FL 33811-2076
Phone
(305) 498-9264
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 13389 FL Primary

Addresses

Primary practice location

5939 Buck Run Dr
Lakeland, FL 33811-2076

Mailing address

5939 Buck Run Dr
Lakeland, FL 33811-2076

Other practice location 1

19881 NW 88th Ave
Hialeah, FL 33018-6203
Phone (305) 498-9264

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
13389FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661990400000",
    "number": "1235859802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5939 BUCK RUN DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338112076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5939 BUCK RUN DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338112076",
            "telephone_number": "305-498-9264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19881 NW 88th Ave",
            "address_purpose": "LOCATION",
            "city": "Hialeah",
            "state": "FL",
            "postal_code": "330186203",
            "country_code": "US",
            "telephone_number": "305-498-9264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNINGS",
        "first_name": "VIVIAN",
        "middle_name": "MARGARETH",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2022-09-01",
        "certification_date": "2022-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "13389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; 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.