Individual provider Active NPI

Victoria Rita Rose, MSOT, OTR/L

  • Occupational Therapist
  • Myrtle Beach, SC
National Provider Identifier
1497340335
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT.6081 Issued in SC
Practice address
101 Fountain Pointe LN Unit 302
Myrtle Beach, SC 29579-7416
Phone
(845) 421-1803
NPI assigned
Mar 3, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 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 OT.6081 SC Primary

Addresses

Primary practice location

101 Fountain Pointe LN Unit 302
Myrtle Beach, SC 29579-7416

Mailing address

101 Fountain Pointe LN Unit 302
Myrtle Beach, SC 29579-7416

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210412001371 SC Practitioner - Occupational Therapist in Private Practice 7911315916 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6081SCMDPhysical Therapist
OT.6081SCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Weston Group of South Carolina Inc Occupational Therapist CurrentSince Mar 23, 2021 Accepting new patients

Locations

872 Singleton Ridge Rd
Conway, SC 29526
Phone (843) 347-3050

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": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1497340335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 FOUNTAIN POINTE LN UNIT 302",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295797416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 FOUNTAIN POINTE LN UNIT 302",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295797416",
            "telephone_number": "845-421-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "VICTORIA",
        "middle_name": "RITA",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "OT.6081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.