Individual provider Active NPI

Mary Laura Naylor Hultgren, MOTR/L

  • Occupational Therapist
  • Manchester Center, VT
National Provider Identifier
1639566268
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
7254 Main St
Manchester Center, VT 05255-9531
Phone
(802) 362-1151
NPI assigned
Apr 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X VT Primary

Addresses

Primary practice location

7254 Main St
Manchester Center, VT 05255-9531

Mailing address

314 Lake Dr
North Bennington, VT 05257-9167
Phone (540) 222-7292

Other names 1

  • Mary Laura Naylor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230907001583 VT Practitioner - Occupational Therapist in Private Practice 2668836842 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Suite 1365
Manchester Center, VT 05255-1365

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Rehabilitation, PC CurrentSince Aug 23, 2023 Accepting new patients

Locations

7254 Main St
Manchestr Ctr, VT 05255
Phone (802) 362-1151

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1639566268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 LAKE DR",
            "city": "NORTH BENNINGTON",
            "state": "VT",
            "postal_code": "052579167",
            "telephone_number": "540-222-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7254 MAIN ST",
            "city": "MANCHESTER CENTER",
            "state": "VT",
            "postal_code": "052559531",
            "telephone_number": "802-362-1151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HULTGREN",
        "first_name": "MARY",
        "middle_name": "LAURA NAYLOR",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-04-21",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "NAYLOR",
            "middle_name": "LAURA",
            "credential": "MOTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Manchester Center, VT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.

Verify at the official NPI Registry.