VIRENDER K GAUTAM OT NPI 1205867157

NPI Information

NPI: 1205867157
Provider Name: VIRENDER K GAUTAM, OT
Classification: Occupational Therapist - 225XN1300X
Entity Type: Individual

Specialization: Neurorehabilitation

Address:
15 EVONVALE COURT
GREENVILLE, SC
ZIP 29605
Phone: (509) 431-2795
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Virender K Gautam, OT is a neurorehabilitation occupational therapist in Greenville, SC. Virender K Gautam, OT NPI is 1205867157. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

15 EVONVALE COURT
GREENVILLE, SC
ZIP 29605
Phone: (509) 431-2795

The enumeration date for this NPI number is 7/6/2006 and was last updated on 7/30/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225XN1300X	Occupational Therapist	Neurorehabilitation	3389	SOUTH CAROLINA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0192967	OTHER	WASHINGTON	L&I
2	G8861896	MEDICARE PIN	WASHINGTON
3	8414856	MEDICAID	WASHINGTON
4	Q32452	MEDICARE UPIN	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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