Active NPI
Anissa Wanamaker
- Occupational Therapy Assistant
- Smithville, TN
National Provider Identifier
1013441120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2411
- Practice address
- 825 Fisher Ave
Smithville, TN 37166-2140 - Phone
- (931) 597-6880
- NPI assigned
- Apr 14, 2017
- Sex
- Female
- 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 | 2411 | TN | Primary |
Addresses
Primary practice location
825 Fisher Ave
Smithville, TN 37166-2140
Mailing address
825 Fisher Ave
Smithville, TN 37166-2140
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 |
|---|---|---|---|
| 2411 | TN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492128000000",
"number": "1013441120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "825 FISHER AVE",
"city": "SMITHVILLE",
"state": "TN",
"postal_code": "371662140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 FISHER AVE",
"city": "SMITHVILLE",
"state": "TN",
"postal_code": "371662140",
"telephone_number": "931-597-6880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANAMAKER",
"first_name": "ANISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-14",
"last_updated": "2017-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TN",
"license": "2411",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.