Individual provider Active NPI

Andrew Todd Wilhelm, COTA/L

  • Occupational Therapy Assistant
  • Panama City Beach, FL
National Provider Identifier
1013306299
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA 10348 Issued in FL
Practice address
218 San Pablo St
Panama City Beach, FL 32413-2328
Phone
(850) 867-3175
NPI assigned
Jan 12, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OTA 10348 FL Primary

Addresses

Primary practice location

218 San Pablo St
Panama City Beach, FL 32413-2328

Mailing address

218 San Pablo St
Panama City Beach, FL 32413-2328
Phone (850) 867-3175

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

LicenseStateTypeSpecialty
OTA 10348FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421020800000",
    "number": "1013306299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 SAN PABLO ST",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324132328",
            "telephone_number": "850-867-3175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 SAN PABLO ST",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324132328",
            "telephone_number": "850-867-3175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHELM",
        "first_name": "ANDREW",
        "middle_name": "TODD",
        "name_prefix": "Mr.",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-12",
        "last_updated": "2015-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA 10348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Panama City Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.