Active NPI
Nikki Kai Wilson, OT003469
- Occupational Therapist
- Atlanta, GA
National Provider Identifier
1215013479
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT003469
- Practice address
- 1200 Lake Hearn Dr NE
Suite 250
Atlanta, GA 30319-1415 - Phone
- (404) 943-1070
- Fax
- (404) 943-0890
- NPI assigned
- Oct 31, 2006
- Sex
- Female
- Sole proprietor
- No
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 | OT003469 | GA | Primary |
Addresses
Primary practice location
1200 Lake Hearn Dr NE
Suite 250
Atlanta, GA 30319-1415
Mailing address
3316 S Cobb Dr SE
Suite a
Smyrna, GA 30080-4118
Phone (678) 523-3571
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 |
|---|---|---|---|
| 003469 | GA | MD | Family Medicine Physician |
| OT003469 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215013479",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3316 S COBB DR SE",
"address_2": "SUITE A",
"city": "SMYRNA",
"state": "GA",
"postal_code": "300804118",
"telephone_number": "678-523-3571"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 LAKE HEARN DR NE",
"address_2": "SUITE 250",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303191415",
"telephone_number": "404-943-1070",
"fax_number": "404-943-0890"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "NIKKI",
"middle_name": "KAI",
"credential": "OT003469",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT003469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.