Active NPI
Mary T Vuong, OTR
- Occupational Therapist
- Great Bend, KS
National Provider Identifier
1861707580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 17-02629
- Practice address
- 3515 Broadway Ave
Great Bend, KS 67530-3633 - Phone
- (620) 786-6111
- NPI assigned
- Aug 18, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 17-02629 | KS | Primary |
Addresses
Primary practice location
3515 Broadway Ave
Great Bend, KS 67530-3633
Mailing address
3515 Broadway Ave
Great Bend, KS 67530-3633
Phone (620) 786-6111
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17-02629 | KS | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282089600000",
"number": "1861707580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3515 BROADWAY AVE",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675303633",
"telephone_number": "620-786-6111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3515 BROADWAY AVE",
"city": "GREAT BEND",
"state": "KS",
"postal_code": "675303633",
"telephone_number": "620-786-6111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VUONG",
"first_name": "MARY",
"middle_name": "T",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-08-18",
"last_updated": "2010-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KS",
"license": "17-02629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Great Bend, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.