Lauren Vistarakula, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

0119007276 Issued in VA

Practice address

4335 Brambleton Ave
Roanoke, VA 24018-3404

Phone

(540) 315-3210

Fax

(540) 566-5149

NPI assigned

Jul 5, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lauren Pittard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Kidable Therapy

  dba Kidable

  • Pediatric Occupational Therapist
  • Roanoke, VA
  • NPI 1922883453
  NPD Authorized official

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

{
    "created_epoch": "1593907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1477170512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4335 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183404",
            "telephone_number": "540-315-3210",
            "fax_number": "540-566-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4335 BRAMBLETON AVE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183404",
            "telephone_number": "540-315-3210",
            "fax_number": "540-566-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VISTARAKULA",
        "first_name": "LAUREN",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-05",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119007276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "PITTARD",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Vistar Eye Center
• Vistar Eye Center, Inc
• Vistar Eye Center, Inc
• Vistar Eye Center, Inc
• Vistar Eye Center, Inc
• Kelley Widel Vitolo, CSFA
• Amy A Vizcarra, DO
• Bogdan Laurentiu Vladu, MPA-C
• Nicholas Vogel, LCMHCA, NCC
• Kevin Vogeley, MD

• Occupational Therapist in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Occupational Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2024; 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.