NPIMap

Individual provider Active NPI

Beverly Vandevender Phillips, OTR/L

  • Environmental Modification Occupational Therapist
  • Omaha, NE
National Provider Identifier
1679032932
Registry record updated Mar 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Environmental Modification Occupational TherapistTaxonomy code 225XE0001X
License
646 Issued in NE
Practice address
7228 Burt St
Omaha, NE 68114-3234
Phone
(402) 306-4028
NPI assigned
Mar 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapist 225XE0001X 01422 IA
Environmental Modification Occupational Therapist 225XE0001X 646 NE Primary

Addresses

Primary practice location

7228 Burt St
Omaha, NE 68114-3234

Mailing address

7228 Burt St
Omaha, NE 68114-3234
Phone (402) 291-3258

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
01422IAMDEnvironmental Modification Occupational Therapist
646NEMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1552780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552780800000",
    "number": "1679032932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7228 BURT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143234",
            "telephone_number": "402-291-3258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7228 BURT ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681143234",
            "telephone_number": "402-306-4028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "BEVERLY",
        "middle_name": "VANDEVENDER",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-17",
        "last_updated": "2019-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "IA",
            "license": "01422",
            "primary": false
        },
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": "NE",
            "license": "646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2019; 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.