Nanette Yvonne Iceberg, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

32001804A Issued in IN

Practice address

405 Rio Vista LN
Rising Sun, IN 47040-9497

Phone

(812) 438-2219

NPI assigned

Jun 2, 2010

Last updated

Jun 2, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1275436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275436800000",
    "number": "1407176423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13418 ABERDEEN RD",
            "city": "DILLSBORO",
            "state": "IN",
            "postal_code": "470185115",
            "telephone_number": "812-667-6318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 RIO VISTA LN",
            "city": "RISING SUN",
            "state": "IN",
            "postal_code": "470409497",
            "telephone_number": "812-438-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ICEBERG",
        "first_name": "NANETTE",
        "middle_name": "YVONNE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-02",
        "last_updated": "2010-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IN",
            "license": "32001804A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Marie Craig, APRN
• Jamie Lynn Elliott, P.T.A.
• Melissa Ann Hall, DPT
• Andrea Halloran, PTA
• Healthcare Centers of Indiana, LLC (the Waters of Rising Sun)
• Laura Jones
• William Joseph Lewis, M.A., CCC-SLP
• Major Hospital (The Waters of Rising Sun)
• Tricia Ann Metz, COTA
• Brittany Ann Muench, PA-C

• Occupational Therapy Assistant in Rising Sun, IN
• Providers in Rising Sun, IN by specialty
• Occupational Therapy Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.