Individual provider Active NPI

Alexis Wilkie

  • Occupational Therapist
  • Glendale, AZ
National Provider Identifier
1043624901
Registry record updated Jul 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119006549 Issued in VA
Practice address
4545 W Beardsley Rd
Apt 2004
Glendale, AZ 85308-5014
Phone
(623) 815-4156
NPI assigned
Jun 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5433 AZ
Occupational Therapist 225X00000X 0119006549 VA Primary

Addresses

Primary practice location

4545 W Beardsley Rd
Apt 2004
Glendale, AZ 85308-5014

Mailing address

4545 W Beardsley Rd
Apt 2004
Glendale, AZ 85308-5014
Phone (623) 815-4156

Other identifiers 1

IdentifierTypeStateIssuer
5433OtherAZLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230602001945 VA Practitioner - Occupational Therapist in Private Practice 3274759667 Reassigns benefits to 1 organization
I20230605000005 DC Practitioner - Occupational Therapist in Private Practice 3274759667 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Therapeutics LTDGroup PAC ID 8921230137, 324 clinicians

Practice addresses (Care Compare)

9619 Burke Lake Rd
Burke, VA 22015-3004
Phone (703) 250-1637

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
0119006549VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Apr 22, 2023 Accepting new patients
Comprehensive Therapeutics LTD Occupational Therapist CurrentSince Apr 22, 2023 Accepting new patients

Locations

10286 Brook Rd
Glen Allen, VA 23059
Phone (571) 200-6617

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1043624901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4545 W BEARDSLEY RD",
            "address_2": "APT 2004",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085014",
            "telephone_number": "623-815-4156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4545 W BEARDSLEY RD",
            "address_2": "APT 2004",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085014",
            "telephone_number": "623-815-4156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKIE",
        "first_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "5433",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119006549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5433",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.