Active NPI
Stacey Vrtiska, OTR/L, CLT
- Occupational Therapist
- Hamburg, IA
National Provider Identifier
1851713820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 002263
- Practice address
- 2959 US Highway 275
Hamburg, IA 51640-5052 - Phone
- (712) 382-1515
- Fax
- (712) 382-1503
- NPI assigned
- Jan 10, 2014
- Sex
- Female
- Sole proprietor
- No
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 | 1298 | NE | |
| Occupational Therapist | 225X00000X | 002263 | IA | Primary |
Addresses
Primary practice location
2959 US Highway 275
Hamburg, IA 51640-5052
Mailing address
2959 US Highway 275
Hamburg, IA 51640-5052
Phone (712) 382-1515
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 |
|---|---|---|---|
| 1298 | NE | MD | Pulmonary Disease Physician |
| 002263 | IA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1389312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389312000000",
"number": "1851713820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2959 US HIGHWAY 275",
"city": "HAMBURG",
"state": "IA",
"postal_code": "516405052",
"telephone_number": "712-382-1515",
"fax_number": "712-382-1503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2959 US HIGHWAY 275",
"city": "HAMBURG",
"state": "IA",
"postal_code": "516405052",
"telephone_number": "712-382-1515",
"fax_number": "712-382-1503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VRTISKA",
"first_name": "STACEY",
"credential": "OTR/L, CLT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-01-10",
"last_updated": "2014-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "1298",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "002263",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamburg, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.