Individual provider Active NPI

Vondie Burrola, COTA/L

  • Occupational Therapy Assistant
  • Albuquerque, NM
National Provider Identifier
1386065282
Registry record updated Dec 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
1889 Issued in NM
Practice address
7427 Via Cometa SW
Albuquerque, NM 87121-5138
Phone
(505) 459-8862
NPI assigned
Dec 18, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2013

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 1889 NM Primary

Addresses

Primary practice location

7427 Via Cometa SW
Albuquerque, NM 87121-5138

Mailing address

7427 Via Cometa SW
Albuquerque, NM 87121-5138
Phone (505) 459-8862

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
1889NMMDPeer Specialist

NPI Registry JSON

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

{
    "created_epoch": "1387324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1386065282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7427 VIA COMETA SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871215138",
            "telephone_number": "505-459-8862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7427 VIA COMETA SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871215138",
            "telephone_number": "505-459-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURROLA",
        "first_name": "VONDIE",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-18",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NM",
            "license": "1889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.