Active NPI
Amy Elizabeth Vanderveer, OTR/L
- Pediatric Occupational Therapist
- Gunnison, CO
National Provider Identifier
1619119435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT.0006107
- Practice address
- 107 E Georgia Ave
Gunnison, CO 81230-2256 - Phone
- (970) 641-2908
- NPI assigned
- Mar 25, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | OT.0006107 | CO | Primary |
| Occupational Therapist | 225X00000X | 013 | WY |
Addresses
Primary practice location
107 E Georgia Ave
Gunnison, CO 81230-2256
Mailing address
353 Meadow Lark TRL
Gunnison, CO 81230-9229
Phone (307) 899-6517
Other practice location 1
4 North Fork Rd
Ft Washakie, WY 82514
Phone (307) 332-3290
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MSAHR0399 | Medicaid | WY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 013 | WY | MD | Occupational Therapist |
| OT.0006107 | CO | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237939200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602028800000",
"number": "1619119435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "353 MEADOW LARK TRL",
"city": "GUNNISON",
"state": "CO",
"postal_code": "812309229",
"telephone_number": "307-899-6517"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "107 E GEORGIA AVE",
"city": "GUNNISON",
"state": "CO",
"postal_code": "812302256",
"telephone_number": "970-641-2908"
}
],
"practiceLocations": [
{
"address_1": "4 North Fork Rd",
"address_purpose": "LOCATION",
"city": "Ft Washakie",
"state": "WY",
"postal_code": "82514",
"country_code": "US",
"telephone_number": "307-332-3290",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VANDERVEER",
"first_name": "AMY",
"middle_name": "ELIZABETH",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-03-25",
"last_updated": "2020-10-07",
"certification_date": "2020-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "CO",
"license": "OT.0006107",
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WY",
"license": "013",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MSAHR0399",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gunnison, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.