Amanda Rose Vander Wiel, OT R/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

4091 Issued in NM

Practice address

706 La Joya St
Espanola, NM 87532-2877

Phone

(732) 770-6838

NPI assigned

Apr 14, 2019

Last updated

Jul 13, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Espanola Sports Medicine, PA

  dba Espanola Sports Medicine

  • Rehabilitation Clinic/Center
  • Espanola, NM
  • NPI 1982777850
  NPD

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

{
    "created_epoch": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1700449931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 HEYER RD",
            "city": "NAZARETH",
            "state": "PA",
            "postal_code": "180648773",
            "telephone_number": "732-770-6838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 LA JOYA ST",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "875322877",
            "telephone_number": "732-770-6838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER WIEL",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "credential": "OT R/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-14",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "4091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristal Martinez Valdez, MS, CCC-SLP
• Leann Valdez
• Rebecca Valdez
• Felix C. Valencia Jr.
• Brent J. Van Andel, M.D.
• Vdex Diabetes NM-Brown
• Catherine L. Veilleux, FNP
• Celina Velasquez
• Laurel Rose Ver Burg
• Joyce Joann Viarrial, LMHC

• Occupational Therapist in Espanola, NM
• Providers in Espanola, NM by specialty
• Occupational Therapist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.