Individual provider Active NPI

Amy L Vanruden, OTR

  • Occupational Therapist
  • Greenfield, WI
National Provider Identifier
1902070600
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
561-026 Issued in WI
Practice address
5700 W Layton Ave
Greenfield, WI 53220-4016
Phone
(414) 325-4040
Fax
(414) 282-7512
NPI assigned
Apr 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

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 561-026 WI Primary

Addresses

Primary practice location

5700 W Layton Ave
Greenfield, WI 53220-4016

Mailing address

6634 Wind Crest Dr
Wind Lake, WI 53185-2783
Phone (262) 895-7042

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
561-026WIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1902070600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6634 WIND CREST DR",
            "city": "WIND LAKE",
            "state": "WI",
            "postal_code": "531852783",
            "telephone_number": "262-895-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 W LAYTON AVE",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532204016",
            "telephone_number": "414-325-4040",
            "fax_number": "414-282-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANRUDEN",
        "first_name": "AMY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "561-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.