Simon Wise, COTA

Primary specialty

Feeding, Eating & Swallowing Occupational Therapy AssistantTaxonomy code 224ZF0002X

Practice address

110 W Wissahickon Ave
Flourtown, PA 19031-1802

Phone

(215) 836-4179

NPI assigned

Feb 14, 2019

Last updated

Feb 14, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550102400000",
    "number": "1083170062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 STEVENS CT",
            "city": "SOMERDALE",
            "state": "NJ",
            "postal_code": "080833007",
            "telephone_number": "469-396-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 W WISSAHICKON AVE",
            "city": "FLOURTOWN",
            "state": "PA",
            "postal_code": "190311802",
            "telephone_number": "215-836-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "SIMON",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-02-14",
        "last_updated": "2019-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224ZF0002X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant, Feeding, Eating & Swallowing",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anestasia Wharton, APN, FNP-C
• Whitemarsh Medical Services, LLC
• Robert John Wieman, PHD
• Wendy A Wiese, D.O.
• Britney N. Wilson
• Wissahickon Orthopaedic Specialists P.C.
• Jeremy Wolf, ND
• Woodbine Audiologic Associates, LLC (Flourtown Audiology)
• Lynne Yellenberg
• Celeste Yun-Ming Yeoh

• Occupational Therapy Assistant in Flourtown, PA
• Providers in Flourtown, PA by specialty
• Occupational Therapy Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2019; 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.