Active NPI
Tara M Waldhauer, MA
- Occupational Therapist
- Aiken, SC
National Provider Identifier
1871617860
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT 2551
- Practice address
- 1000 Brookhaven Dr
Aiken, SC 29803-2109 - Phone
- (803) 641-2624
- NPI assigned
- Mar 17, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT 2551 | SC | Primary |
Addresses
Primary practice location
1000 Brookhaven Dr
Aiken, SC 29803-2109
Mailing address
222 Walnut LN
North Augusta, SC 29860-9215
Phone (803) 279-6110
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT 2551 | SC | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174089600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871617860",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 WALNUT LN",
"city": "NORTH AUGUSTA",
"state": "SC",
"postal_code": "298609215",
"telephone_number": "803-279-6110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BROOKHAVEN DR",
"city": "AIKEN",
"state": "SC",
"postal_code": "298032109",
"telephone_number": "803-641-2624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDHAUER",
"first_name": "TARA",
"middle_name": "M",
"name_prefix": "Mrs.",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-17",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "SC",
"license": "OT 2551",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aiken, SC
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.