Individual provider Active NPI

Rachel H Vickers

  • Occupational Therapist
  • Melbourne, FL
National Provider Identifier
1366773186
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT13904 Issued in ZZ
Practice address
1800 Penn St Ste 312
Melbourne, FL 32901-2643
Phone
(321) 768-6800
Fax
(321) 768-6858
NPI assigned
Jan 18, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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 OT13904 ZZ Primary

Addresses

Primary practice location

1800 Penn St Ste 312
Melbourne, FL 32901-2643

Mailing address

709 Lund Cir
Melbourne, FL 32901-4113
Phone (321) 768-6800

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT13904ZZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Haven Therapy Occupational Therapist Current Accepting new patients
PTS Staffing LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1263772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263772800000",
    "number": "1366773186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 LUND CIR",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329014113",
            "telephone_number": "321-768-6800",
            "fax_number": "321-768-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 PENN ST STE 312",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329012643",
            "telephone_number": "321-768-6800",
            "fax_number": "321-768-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICKERS",
        "first_name": "RACHEL",
        "middle_name": "H",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-18",
        "last_updated": "2010-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ZZ",
            "license": "OT13904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2010; 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.