Active NPI
Tyler Joseph Metroff, OTR/L
- Occupational Therapist
- Rutland, VT
National Provider Identifier
1700449766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 072.0134069
- Practice address
- 5 Albert Cree Dr
Rutland, VT 05701-4601 - Phone
- (802) 775-1300
- NPI assigned
- Apr 16, 2019
- Last updated
- Apr 16, 2019
- Sex
- Male
- Sole proprietor
- No
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 | 072.0134069 | VT | Primary |
Addresses
Primary practice location
5 Albert Cree Dr
Rutland, VT 05701-4601
Mailing address
10030 W Lake Camelot Dr
Mapleton, IL 61547-9528
Phone (309) 397-6239
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
| License | State | Type | Specialty |
|---|---|---|---|
| 072.0134069 | VT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1555372800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555372800000",
"number": "1700449766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10030 W LAKE CAMELOT DR",
"city": "MAPLETON",
"state": "IL",
"postal_code": "615479528",
"telephone_number": "309-397-6239"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 ALBERT CREE DR",
"city": "RUTLAND",
"state": "VT",
"postal_code": "057014601",
"telephone_number": "802-775-1300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METROFF",
"first_name": "TYLER",
"middle_name": "JOSEPH",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-16",
"last_updated": "2019-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "VT",
"license": "072.0134069",
"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 Apr 16, 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.