Individual provider Active NPI

Aline Fawzi Wimberly, OTR/L

  • Occupational Therapist
  • Clarksville, TN
National Provider Identifier
1093945040
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0000003971 Issued in TN
Practice address
396 Augusta PL
Clarksville, TN 37043-6722
Phone
(614) 570-8918
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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 0000003971 TN Primary

Addresses

Primary practice location

396 Augusta PL
Clarksville, TN 37043-6722

Mailing address

396 Augusta PL
Clarksville, TN 37043
Phone (614) 570-8918

Other identifiers 1

IdentifierTypeStateIssuer
000000000000000OtherTNNOT SURE, I WORK FOR A HOSPITAL

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
0000003971TNMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1093945040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "396 AUGUSTA PL",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "37043",
            "telephone_number": "614-570-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "396 AUGUSTA PL",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436722",
            "telephone_number": "614-570-8918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMBERLY",
        "first_name": "ALINE",
        "middle_name": "FAWZI",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "0000003971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT SURE, I WORK FOR A HOSPITAL",
            "identifier": "000000000000000",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; 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.