Raegan Elizabeth Anderson, MOT, OTR/L
Individual provider Active NPI Occupational Therapist · Pender, NE
NPI 1972186773 · NPPES record last updated Sep 20, 2022
Key facts
- NPI
- 1972186773
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 2523 (NE)
- Practice address
- 100 Hospital Dr
Pender, NE 68047-4507 - Phone
- (402) 385-3083
- NPI assigned
- Apr 30, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2523 | NE | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 2523 | NE | Yes |
Addresses
Primary practice location
100 Hospital Dr
Pender, NE 68047-4507
Mailing address
1181 15TH Rd
Pender, NE 68047-4098
NPI Registry JSON
{
"created_epoch": "1619740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663632000000",
"number": "1972186773",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1181 15TH RD",
"city": "PENDER",
"state": "NE",
"postal_code": "680474098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOSPITAL DR",
"city": "PENDER",
"state": "NE",
"postal_code": "680474507",
"telephone_number": "402-385-3083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "RAEGAN",
"middle_name": "ELIZABETH",
"name_prefix": "Miss",
"credential": "MOT, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-30",
"last_updated": "2022-09-20",
"certification_date": "2022-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "2523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pender, NE
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- Behavioral Health Specialists Inc
- Rashawnda Janice Belton
- Justice Brehmer
- County of Thurston School District 1
- Dregalla Family Dentistry
All providers in Pender, NE · Occupational Therapist in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.