Active NPI
Katie Vandenberge, OTR/L
- Occupational Therapist
- Matthews, NC
National Provider Identifier
1770745408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1863
- Practice address
- 114 Savannah Dr
Matthews, NC 28105-6527 - Phone
- (704) 846-4901
- NPI assigned
- Jun 25, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1863 | NC | Primary |
| Pediatric Occupational Therapist | 225XP0200X | 1863 | NC |
Addresses
Primary practice location
114 Savannah Dr
Matthews, NC 28105-6527
Mailing address
114 Savannah Dr
Matthews, NC 28105-6527
Phone (704) 846-4901
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1863 | NC | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1770745408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 SAVANNAH DR",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281056527",
"telephone_number": "704-846-4901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 SAVANNAH DR",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281056527",
"telephone_number": "704-846-4901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANDENBERGE",
"first_name": "KATIE",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-25",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "1863",
"primary": true
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NC",
"license": "1863",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Matthews, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.