Individual provider Active NPI

Bobbie Jo Vergo, OTD, OTR

  • Occupational Therapist
  • Indianapolis, IN
National Provider Identifier
1639478787
Registry record updated Mar 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31005110A Issued in IN
Practice address
6268 Brookline Dr
Indianapolis, IN 46220-6707
Phone
(317) 756-8415
NPI assigned
Mar 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31005110A IN Primary
Mental Health Occupational Therapist 225XM0800X 31005110A IN
Pediatric Occupational Therapist 225XP0200X 31005110A IN

Addresses

Primary practice location

6268 Brookline Dr
Indianapolis, IN 46220-6707

Mailing address

6268 Brookline Dr
Indianapolis, IN 46220-6707
Phone (317) 756-8415

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

LicenseStateTypeSpecialty
31005110AINMDMental Health Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1300147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1639478787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6268 BROOKLINE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462206707",
            "telephone_number": "317-756-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6268 BROOKLINE DR",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462206707",
            "telephone_number": "317-756-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERGO",
        "first_name": "BOBBIE",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "OTD, OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-15",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31005110A",
            "primary": true
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "IN",
            "license": "31005110A",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IN",
            "license": "31005110A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 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.