Active NPI
Daryl Van Nuland
- Occupational Therapy Assistant
- Appleton, WI
National Provider Identifier
1982425815
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 7139-27
- Practice address
- W6160 Pilgrim St
Appleton, WI 54914-9140 - Phone
- (508) 944-7855
- NPI assigned
- Oct 23, 2024
- Sex
- Male
- 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 Therapy Assistant | 224Z00000X | 7139-27 | WI | Primary |
Addresses
Primary practice location
W6160 Pilgrim St
Appleton, WI 54914-9140
Mailing address
W6160 Pilgrim St
Appleton, WI 54914-9140
Phone (508) 944-7855
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
| License | State | Type | Specialty |
|---|---|---|---|
| 7139-27 | WI | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1729641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729641600000",
"number": "1982425815",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "W6160 PILGRIM ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549149140",
"telephone_number": "508-944-7855"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W6160 PILGRIM ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549149140",
"telephone_number": "508-944-7855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN NULAND",
"first_name": "DARYL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-10-23",
"last_updated": "2024-10-23",
"certification_date": "2024-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "WI",
"license": "7139-27",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.