Active NPI
Robert Gordon Vernon, OT
- Occupational Therapist
- Wasilla, AK
National Provider Identifier
1487967550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1112
- Practice address
- 650 N Shoreline Dr Ste 101
Wasilla, AK 99654-6677 - Phone
- (907) 376-6363
- Fax
- (907) 376-6366
- NPI assigned
- Jul 19, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1112 | AK | Primary |
Addresses
Primary practice location
650 N Shoreline Dr Ste 101
Wasilla, AK 99654-6677
Mailing address
650 N Shoreline Dr Ste 101
Wasilla, AK 99654-6677
Phone (907) 376-6363
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Health Quest Therapy, Inc. | 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.
-
- Occupational Therapy Assistant
- Wasilla, AK
- NPI 1982727640
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1279497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279497600000",
"number": "1487967550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "650 N SHORELINE DR STE 101",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546677",
"telephone_number": "907-376-6363",
"fax_number": "907-376-6366"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 N SHORELINE DR STE 101",
"city": "WASILLA",
"state": "AK",
"postal_code": "996546677",
"telephone_number": "907-376-6363",
"fax_number": "907-376-6366"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERNON",
"first_name": "ROBERT",
"middle_name": "GORDON",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-19",
"last_updated": "2010-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AK",
"license": "1112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.