Individual provider Active NPI

Melanie Edson, MS, OTR/L

  • Pediatric Occupational Therapist
  • Colchester, VT
National Provider Identifier
1548555097
Registry record updated Jun 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
072.0058802 Issued in VT
Practice address
905 Roosevelt Hwy
Suite 115
Colchester, VT 05446-4475
Phone
(802) 861-3600
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 072.0058802 VT Primary

Addresses

Primary practice location

905 Roosevelt Hwy
Suite 115
Colchester, VT 05446-4475

Mailing address

67 Union St Apt 2E
Winooski, VT 05404-1948

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
072.0058802VTMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1307923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307923200000",
    "number": "1548555097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 UNION ST APT 2E",
            "city": "WINOOSKI",
            "state": "VT",
            "postal_code": "054041948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 ROOSEVELT HWY",
            "address_2": "SUITE 115",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054464475",
            "telephone_number": "802-861-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDSON",
        "first_name": "MELANIE",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-13",
        "last_updated": "2011-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "VT",
            "license": "072.0058802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colchester, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2011; 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.