Individual provider Active NPI

Vaughn Charles Adlam, OTR/L

  • Physical Rehabilitation Occupational Therapist
  • Valley Stream, NY
National Provider Identifier
1275049355
Registry record updated Dec 27, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
018053 Issued in NY
Practice address
21 Birch LN
Valley Stream, NY 11581-1773
Phone
(917) 476-0595
NPI assigned
Dec 27, 2017
Last updated
Dec 27, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Rehabilitation Occupational Therapist 225XP0019X 018053 NY Primary

Addresses

Primary practice location

21 Birch LN
Valley Stream, NY 11581-1773

Mailing address

9131 175TH St
Jamaica, NY 11432-5517
Phone (718) 657-6363

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

NPI Registry JSON

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514332800000",
    "number": "1275049355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9131 175TH ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325517",
            "telephone_number": "718-657-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 BIRCH LN",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811773",
            "telephone_number": "917-476-0595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADLAM",
        "first_name": "VAUGHN",
        "middle_name": "CHARLES",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-27",
        "last_updated": "2017-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "NY",
            "license": "018053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 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.