Active NPI
Laura Vetter
- Pediatric Occupational Therapist
- Hendersonville, TN
National Provider Identifier
1639546104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- OT3512
- Practice address
- 139 Maple Row Blvd Ste 202
Hendersonville, TN 37075-4492 - Phone
- (208) 310-0296
- NPI assigned
- Aug 31, 2015
- Last updated
- Feb 13, 2017
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT-921 | ID | |
| Occupational Therapist | 225X00000X | OT 00003794 | WA | |
| Pediatric Occupational Therapist | 225XP0200X | OT3512 | TN | Primary |
Addresses
Primary practice location
139 Maple Row Blvd Ste 202
Hendersonville, TN 37075-4492
Mailing address
605 Dorothy Dr Apt a
Goodlettsville, TN 37072-3416
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Occupational Therapist in Private Practice
- Education
- Loma Linda University School of Medicine, 2003
- Medicare assignment
- May accept Medicare assignment
- Group practices
Practice addresses (Care Compare)
113 Cumberland Ave
Suite 110
Madison, TN 37115-3339
Phone (615) 596-1830
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3512 | TN | MD | Mental Health Counselor |
| OT-921 | ID | MD | Occupational Therapist |
| OT 00003794 | WA | MD | Occupational Therapist |
| OT3512 | TN | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ellenbecker and Borsellino PLLC | Current | Accepting new patients |
Locations
113 Cumberland Ave
Ste 110
Madison, TN 37115
Phone (615) 596-1830
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440979200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486944000000",
"number": "1639546104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "605 DOROTHY DR APT A",
"city": "GOODLETTSVILLE",
"state": "TN",
"postal_code": "370723416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 MAPLE ROW BLVD STE 202",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370754492",
"telephone_number": "208-310-0296"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VETTER",
"first_name": "LAURA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-08-31",
"last_updated": "2017-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "OT-921",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WA",
"license": "OT 00003794",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "TN",
"license": "OT3512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.