Individual provider Active NPI

Vesna C Costello, OTR-L

  • Occupational Therapist
  • Roanoke, VA
National Provider Identifier
1851438196
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119004260 Issued in VA
Practice address
2727 Electric Rd
Suite 104
Roanoke, VA 24018-3547
Phone
(540) 961-1230
Fax
(540) 951-0613
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 0119004260 VA Primary

Addresses

Primary practice location

2727 Electric Rd
Suite 104
Roanoke, VA 24018-3547

Mailing address

245 Bluegrass Trail
Newport, VA 24128
Phone (540) 961-1230

Other identifiers 1

IdentifierTypeStateIssuer
7413822OtherVAAETNA

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

LicenseStateTypeSpecialty
0119004260VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851438196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 BLUEGRASS TRAIL",
            "city": "NEWPORT",
            "state": "VA",
            "postal_code": "24128",
            "telephone_number": "540-961-1230",
            "fax_number": "540-951-0613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 ELECTRIC RD",
            "address_2": "SUITE 104",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183547",
            "telephone_number": "540-961-1230",
            "fax_number": "540-951-0613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSTELLO",
        "first_name": "VESNA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "OTR-L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119004260",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7413822",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.