Individual provider Active NPI

Megan Leigh Wittenberg, OT/L

  • Occupational Therapist
  • Midlothian, VA
National Provider Identifier
1841425063
Registry record updated Jun 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119005510 Issued in VA
Practice address
14318 Camack TRL
Midlothian, VA 23114-4328
Phone
(330) 322-0212
NPI assigned
May 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2012

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 0119005510 VA Primary

Addresses

Primary practice location

14318 Camack TRL
Midlothian, VA 23114-4328

Mailing address

14318 Camack TRL
Midlothian, VA 23114-4328
Phone (330) 322-0212

Other identifiers 1

IdentifierTypeStateIssuer
1841425063OtherVANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210730001583 OH Practitioner - Occupational Therapist in Private Practice 1850794603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Enliven Rehabilitation Services LLCGroup PAC ID 1850626375, 10 clinicians

Practice addresses (Care Compare)

630 Morrison Rd
Suite 310
Gahanna, OH 43230-5318
Phone (614) 755-2347

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119005510VAMDOccupational Therapist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1242604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340236800000",
    "number": "1841425063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14318 CAMACK TRL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144328",
            "telephone_number": "330-322-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14318 CAMACK TRL",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231144328",
            "telephone_number": "330-322-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTENBERG",
        "first_name": "MEGAN",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "OT/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-18",
        "last_updated": "2012-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119005510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1841425063",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.