Audrey Jennings Vidrine, LCOTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

321501 Issued in LA

Practice address

3001 Armand St Ste I
Monroe, LA 71201-3761

Phone

(318) 302-6000

NPI assigned

Jun 3, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Melanie Massey Physical Therapy Inc

  • Physical Therapist
  • Monroe, LA
  • NPI 1104922475

  Occupational Therapist

  Medicare reassignment NPD
• Melanie Massey Infant & Toddler LLC

  • Speech-Language Pathologist
  • West Monroe, LA
  • NPI 1447453865

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1982343281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 EISENHOWER DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712036812",
            "telephone_number": "318-464-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 ARMAND ST STE I",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712013761",
            "telephone_number": "318-302-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDRINE",
        "first_name": "AUDREY",
        "middle_name": "JENNINGS",
        "name_prefix": "Mrs.",
        "credential": "LCOTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "LA",
            "license": "321501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LSBME",
            "identifier": "321501",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Veazey, PHARMD
• Allison R Venable, MA, CCC-SLP
• Andrea Danelle Vermillion-Guy, CAC
• Elizabeth Pearson Vetrano, LPC
• Rebecca Ann Vickery, NP
• Belle Vignes
• Otto F Villa, MD
• Pamela Villemarette
• Richard Van Vines II, MD
• Vipul Shelat Apmc

• Occupational Therapy Assistant in Monroe, LA
• Providers in Monroe, LA by specialty
• Occupational Therapy Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.