Individual provider Active NPI

George Vartanian, OTR/L

  • Occupational Therapist
  • Irvine, CA
National Provider Identifier
1730714833
Registry record updated Mar 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
21024 Issued in CA
Practice address
22 Winterhaven
Irvine, CA 92614-7914
Phone
(949) 664-6740
NPI assigned
Mar 9, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 21024 CA Primary

Addresses

Primary practice location

22 Winterhaven
Irvine, CA 92614-7914

Mailing address

22 Winterhaven
Irvine, CA 92614-7914
Phone (949) 664-6740

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
21024CAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Occupational Therapist CurrentSince Oct 30, 2023 Accepting new patients
Legacy Healthcare Services Inc. Occupational Therapist CurrentSince Oct 30, 2023 Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

2300 Pool Rd
Grapevine, TX 76051
Phone (682) 294-8236

2300 Pool Rd
#G
Grapevine, TX 76051
Phone (833) 655-2840

Organizations & group practices 2

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": "1583712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1730714833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 WINTERHAVEN",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926147914",
            "telephone_number": "949-664-6740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 WINTERHAVEN",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926147914",
            "telephone_number": "949-664-6740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARTANIAN",
        "first_name": "GEORGE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-09",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "21024",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.