Active NPI
Pacha Vang, COTA
- Occupational Therapist
- Brookfield, WI
National Provider Identifier
1659958296
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 13900 W Burleigh Rd
Brookfield, WI 53005-3019 - Phone
- (262) 781-0550
- NPI assigned
- Mar 29, 2021
- 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 Therapist | 225X00000X | Primary |
Addresses
Primary practice location
13900 W Burleigh Rd
Brookfield, WI 53005-3019
Mailing address
PO Box 1034
Brookfield, WI 53008-1034
Phone (262) 264-8789
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8618005 | Other | WI | 8618005 |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644883200000",
"number": "1659958296",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1034",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530081034",
"telephone_number": "262-264-8789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13900 W BURLEIGH RD",
"city": "BROOKFIELD",
"state": "WI",
"postal_code": "530053019",
"telephone_number": "262-781-0550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANG",
"first_name": "PACHA",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-29",
"last_updated": "2022-02-15",
"certification_date": "2022-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "8618005",
"identifier": "8618005",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookfield, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.