Individual provider Active NPI

Dana Wilson, OT

  • Occupational Therapist
  • Memphis, TN
National Provider Identifier
1033632575
Registry record updated Jul 17, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4228 Issued in TN
Practice address
950 Cherry Rd
Memphis, TN 38117-5431
Phone
(901) 930-0817
NPI assigned
Jul 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 4228 TN Primary

Addresses

Primary practice location

950 Cherry Rd
Memphis, TN 38117-5431

Mailing address

711 Avignon Dr
Ridgeland, MS 39157-5120
Phone (601) 605-6777

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
4228TNMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1500249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500249600000",
    "number": "1033632575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 AVIGNON DR",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391575120",
            "telephone_number": "601-605-6777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 CHERRY RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381175431",
            "telephone_number": "901-930-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DANA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-17",
        "last_updated": "2017-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "4228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.

Verify at the official NPI Registry.