Active NPI
Anna Wilder, MOTR/L
- Occupational Therapist
- Santa Fe, NM
National Provider Identifier
1154976181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4130
- Practice address
- 1800 Old Pecos TRL
Santa Fe, NM 87505-4759 - Phone
- (505) 424-8777
- NPI assigned
- Aug 6, 2019
- 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 Therapist | 225X00000X | 4130 | NM | Primary |
Addresses
Primary practice location
1800 Old Pecos TRL
Santa Fe, NM 87505-4759
Mailing address
1262 Senda del Valle
Santa Fe, NM 87507-7178
Phone (505) 920-7966
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 |
|---|---|---|---|
| 4130 | NM | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1565049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1154976181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1262 SENDA DEL VALLE",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875077178",
"telephone_number": "505-920-7966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1800 OLD PECOS TRL",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054759",
"telephone_number": "505-424-8777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDER",
"first_name": "ANNA",
"credential": "MOTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-06",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NM",
"license": "4130",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.