Active NPI
Justine Mary Lercara, C.O.T.A.
- Occupational Therapy Assistant
- Rutland, VT
National Provider Identifier
1659769982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 072.0109090
- Practice address
- 9 Haywood Ave
Rutland, VT 05701-4832 - Phone
- (802) 775-0007
- NPI assigned
- Jan 9, 2015
- Last updated
- Jan 9, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 072.0109090 | VT | Primary |
Addresses
Primary practice location
9 Haywood Ave
Rutland, VT 05701-4832
Mailing address
223A York Street
Poultney, VT 05764
Phone (845) 321-9361
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 |
|---|---|---|---|
| 072.0109090 | VT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420761600000",
"number": "1659769982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "223A YORK STREET",
"city": "POULTNEY",
"state": "VT",
"postal_code": "05764",
"telephone_number": "845-321-9361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9 HAYWOOD AVE",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057014832",
"telephone_number": "802-775-0007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LERCARA",
"first_name": "JUSTINE",
"middle_name": "MARY",
"credential": "C.O.T.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-09",
"last_updated": "2015-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "VT",
"license": "072.0109090",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rutland, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.