Individual provider Active NPI

Rebecca L Vasas, OT

  • Occupational Therapist
  • Pocatello, ID
National Provider Identifier
1275042475
Registry record updated Sep 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT-1776 Issued in ID
Practice address
560 Memorial Dr Ste C
Pocatello, ID 83201-4073
Phone
(208) 904-3311
Fax
(888) 975-1418
NPI assigned
Sep 20, 2017
Last updated
Sep 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2017

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 OT-1776 ID Primary

Addresses

Primary practice location

560 Memorial Dr Ste C
Pocatello, ID 83201-4073

Mailing address

560 Memorial Dr Ste C
Pocatello, ID 83201-4073
Phone (208) 904-3311

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
OT-1776IDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505865600000",
    "number": "1275042475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 MEMORIAL DR STE C",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014073",
            "telephone_number": "208-904-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 MEMORIAL DR STE C",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832014073",
            "telephone_number": "208-904-3311",
            "fax_number": "888-975-1418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASAS",
        "first_name": "REBECCA",
        "middle_name": "L",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-20",
        "last_updated": "2017-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-1776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2017; 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.