Vivian Rae Fields, COTA

Key facts

NPI

1508075458

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapy Assistant 224Z00000X

License

OTA 01982 (OH)

Practice address

5040 W Ford Rd
Ashville, OH 43103-9231

Phone

(614) 395-0155

NPI assigned

May 21, 2007

Sex

Female

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508075458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5040 W FORD RD",
            "city": "ASHVILLE",
            "state": "OH",
            "postal_code": "431039231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5040 W FORD RD",
            "city": "ASHVILLE",
            "state": "OH",
            "postal_code": "431039231",
            "telephone_number": "614-395-0155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIELDS",
        "first_name": "VIVIAN",
        "middle_name": "RAE",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA 01982",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Ashville, OH · Occupational Therapy Assistant in Ohio