NICOLE E VANDENBERG (NPI# 1790026961) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790026961 |
| Entity Type | Individual |
| Full Name | NICOLE E VANDENBERG |
| Credential | C.O.T.A |
| Practice Address |
107 E Beckert Rd New London WI 54961-2509 |
| Mailing Address |
W4849 Pleasant Rd Appleton WI 54913-9748 |
| Practice Telephone | 9209825354 |
| Mailing Telephone | 9206592735 |
| Enumeration Date | 2013-03-12 |
| Last Update Date | 2013-03-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 224Z00000X | Occupational Therapy Assistant | 289906 | WI | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790002392 | Nicole Lynn Vandenberg | Family Medicine | 3 Century Ave., Hutchinson, MN 55350 | 2010-04-23 |
| Street Address |
107 E BECKERT RD |
| City | NEW LONDON |
| State | WI |
| Zip Code | 54961-2509 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972730786 | Mary Elaine Millarez Mabayag | Physical Therapist | 107 E Beckert Rd, St. Joseph Residence, New London, WI 54961-2509 | 2009-06-18 |
| 1215575287 | Rachel Lohff | Occupational Therapist | 107 E Beckert Rd, New London, WI 54961-2509 | 2019-12-20 |
| 1902452931 | Danielle Greshamer | Occupational Therapy Assistant | 107 E Beckert Rd, New London, WI 54961-2509 | 2019-08-15 |
| 1669886859 | Theresa Susan Schulze | Occupational Therapy Assistant | 107 E Beckert Rd, New London, WI 54961-2509 | 2014-06-16 |
| 1730500950 | Mary Marie Hansen | Speech-Language Pathologist | 107 E Beckert Rd, New London, WI 54961-2509 | 2013-12-16 |
| 1336488923 | Margit Kindel | Physical Therapy Assistant | 107 E Beckert Rd, New London, WI 54961-2509 | 2013-02-03 |
| 1770822413 | Kathleen Nora Peters | Occupational Therapy Assistant | 107 E Beckert Rd, New London, WI 54961-2509 | 2013-01-31 |
| 1396083374 | Kathy Jean Jensen | Occupational Therapy Assistant | 107 E Beckert Rd, New London, WI 54961-2509 | 2013-01-24 |
| 1902144074 | Sundance Services Corp | Skilled Nursing Facility | 107 E Beckert Rd, New London, WI 54961-2509 | 2013-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407406408 | Cheryl Schneider | Technician | L 56 Northgate Estates, New London, WI 54961 | 2019-09-12 |
| 1861634719 | Rebecca L Kramer | Counselor | 315 Burton St, New London, WI 54961 | 2009-03-24 |
| 1598913501 | Marsha Ann Nytes | Licensed Practical Nurse | E8222 Weyawega Rd, New London, WI 54961 | 2008-09-03 |
| 1659585172 | Amanda L. Beck | Physical Therapy Assistant | 400 E. 4th Street, Manawa, WI 54961 | 2007-05-10 |
| 1366599433 | Griebenow Eyecare, S.c. | Optometrist | 105 Northridge Drive, New London, WI 54961 | 2007-01-04 |
| 1740822055 | Lauren Mae Flunker | Social Worker | E7475 Rawhide Rd, New London, WI 54961 | 2019-10-09 |
| 1063641249 | Forefront Dermatology, S.c. | Dermatology | 1620 N Shawano St, Suite C, New London, WI 54961 | 2009-07-08 |
| 1093982530 | Ascension Medical Group-fox Valley Wisconsin, Inc | Clinic/Center | 1420 Algoma St, New London, WI 54961 | 2008-05-14 |
| 1821263849 | Mark Alan Tegtmeier | Counselor | E7475 Rawhide Rd, New London, WI 54961 | 2008-04-30 |
| 1194910489 | Laurie Mollenhauer | Physical Therapist | 1405 Mill St, New London, WI 54961 | 2007-09-10 |
| Find all providers in zip 54961 | ||||
| Taxonomy Code | 224Z00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapy Assistant |
| An occupational therapy assistant is a person who has graduated from an occupational therapy assistant program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, has successfully completed a period of supervised fieldwork experience required by the accredited occupational therapy assistant program, has passed a nationally recognized entry-level examination for occupational therapy assistants, and fulfills state requirements for licensure, certification, or registration. An occupational therapy assistant provides interventions under the supervision of an occupational therapist which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapy assistants address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467825307 | Lisa Scott | Occupational Therapy Assistant | 602 E Adams St, New London, IA 52645-1708 | 2015-10-31 |
| 1568743037 | Noelle E Cupp | Occupational Therapy Assistant | 1828 Dexter St, New London, WI 54961-2522 | 2011-08-29 |
| 1598912404 | Carrie Hostettler | Occupational Therapy Assistant | N4610 Pine St, New London, WI 54961-8039 | 2008-08-21 |
| 1003443227 | Rene Petrone | Occupational Therapy Assistant | 31 Vauxhall St, New London, CT 06320-5723 | 2020-03-26 |
| 1902452931 | Danielle Greshamer | Occupational Therapy Assistant | 107 E Beckert Rd, New London, WI 54961-2509 | 2019-08-15 |
| 1831669712 | Ash-leigh Marie Kowalczyk | Occupational Therapy Assistant | 307 Smith St, New London, WI 54961-1410 | 2018-12-04 |
| 1619359965 | Meghan Ducharme | Occupational Therapy Assistant | 31 Vauxhall St, New London, CT 06320-5723 | 2015-06-23 |
| 1669886859 | Theresa Susan Schulze | Occupational Therapy Assistant | 107 E Beckert Rd, New London, WI 54961-2509 | 2014-06-16 |
| 1215373824 | Nancy Robin Gluckcoleman | Occupational Therapy Assistant | 31 Vauxhall St, New London, CT 06320-5723 | 2013-05-22 |
| 1770822413 | Kathleen Nora Peters | Occupational Therapy Assistant | 107 E Beckert Rd, New London, WI 54961-2509 | 2013-01-31 |
| Find all providers in NEW LONDON | ||||
| City | NEW LONDON |
| Zip Code | 54961 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.