Individual provider Active NPI

Katee Mary Wilson, COTA, LMT

  • Occupational Therapy Assistant
  • Wells, ME
National Provider Identifier
1194081356
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3506 Issued in MA
Practice address
1662 Post Rd Unit A3
Wells, ME 04090-4638
Phone
(207) 730-0539
NPI assigned
Apr 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3506 MA Primary
Massage Therapist 225700000X MT1271 ME
Occupational Therapy Assistant 224Z00000X 007365-1 NY

Addresses

Primary practice location

1662 Post Rd Unit A3
Wells, ME 04090-4638

Mailing address

1662 Post Rd Unit A3
Wells, ME 04090-4638
Phone (207) 730-0539

Other names 1

  • Kathleen Mary Wilson Other name

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
3506MAMDOccupational Therapy Assistant
007365-1NYMDOccupational Therapy Assistant
MT1271MEMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1194081356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1662 POST RD UNIT A3",
            "city": "WELLS",
            "state": "ME",
            "postal_code": "040904638",
            "telephone_number": "207-730-0539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1662 POST RD UNIT A3",
            "city": "WELLS",
            "state": "ME",
            "postal_code": "040904638",
            "telephone_number": "207-730-0539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KATEE",
        "middle_name": "MARY",
        "credential": "COTA, LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MA",
            "license": "3506",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "ME",
            "license": "MT1271",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NY",
            "license": "007365-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "WILSON",
            "middle_name": "MARY",
            "credential": "COTA, LMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wells, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.