Individual provider Active NPI

Vanessa Eisch, OTR

  • Occupational Therapist
  • Geneva, IL
National Provider Identifier
1376986117
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
056013919 Issued in IL
Practice address
0S580 Preston Cir
Geneva, IL 60134-6140
Phone
(928) 961-0055
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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 056013919 IL Primary

Addresses

Primary practice location

0S580 Preston Cir
Geneva, IL 60134-6140

Mailing address

0S580 Preston Cir
Geneva, IL 60134-6140
Phone (928) 961-0055

Other practice location 1

3541 Plover Rd
Wisconsin Rapids, WI 54494-2155
Phone (715) 423-5423

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
056013919ILMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapies Plus LLC Occupational Therapist Past Accepting new patients

Organizations & group practices 1

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1376986117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "0S580 PRESTON CIR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601346140",
            "telephone_number": "928-961-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "0S580 PRESTON CIR",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601346140",
            "telephone_number": "928-961-0055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3541 Plover Rd",
            "address_purpose": "LOCATION",
            "city": "Wisconsin Rapids",
            "state": "WI",
            "postal_code": "544942155",
            "country_code": "US",
            "telephone_number": "715-423-5423",
            "fax_number": "715-423-1532",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EISCH",
        "first_name": "VANESSA",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IL",
            "license": "056013919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.