Individual provider Active NPI

Vanessa Naidoo, OTRL

  • Occupational Therapist
  • Southaven, MS
National Provider Identifier
1710122122
Registry record updated Aug 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT2230 Issued in MS
Practice address
7075 Golden Oaks Loop W Ste 6
Southaven, MS 38671
Phone
(901) 335-8468
Fax
(662) 349-3988
NPI assigned
Dec 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT0000001837 TN
Occupational Therapist 225X00000X OT2230 MS Primary

Addresses

Primary practice location

7075 Golden Oaks Loop W Ste 6
Southaven, MS 38671

Mailing address

7075 Golden Oaks Loop W Ste 6
Southaven, MS 38671-9011
Phone (901) 335-8468

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

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Zone, LLC CurrentSince Apr 30, 2013 Accepting new patients

Locations

7160 Tchulahoma Rd
Ste B4
Southaven, MS 38671
Phone (662) 349-2733

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1229212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565654400000",
    "number": "1710122122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7075 GOLDEN OAKS LOOP W STE 6",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719011",
            "telephone_number": "901-335-8468",
            "fax_number": "662-349-3988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7075 GOLDEN OAKS LOOP W STE 6",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "38671",
            "telephone_number": "901-335-8468",
            "fax_number": "662-349-3988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIDOO",
        "first_name": "VANESSA",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-14",
        "last_updated": "2019-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT0000001837",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT2230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

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