Miranda Wilson, M.S.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

2125 Issued in WV

Practice address

21 Osprey Rd
Beckley, WV 25801-1605

Phone

(205) 393-4570

NPI assigned

Mar 20, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Occupational Therapy Associates - Watertown, Inc.

  • Clinic/Center
  • Newton, MA
  • NPI 1750429072
  NPD (past)
• Ota the Koomar Center, LLC

  • Pediatric Occupational Therapist
  • Newton, MA
  • NPI 1679167720
  NPD (past)

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

{
    "created_epoch": "1395273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638921600000",
    "number": "1215354857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 HESLEP AVE",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258401145",
            "telephone_number": "205-393-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 OSPREY RD",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258011605",
            "telephone_number": "205-393-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MIRANDA",
        "name_prefix": "Mrs.",
        "credential": "M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-20",
        "last_updated": "2021-12-08",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "120505",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "11169",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WV",
            "license": "2125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Nicole Wilson
• David Ray Wilson III
• Dyneka Wilson
• Keri Wilson, BSN
• Lisa Wilson
• Vicki Lynn Wilson
• Wendy Ladawn Wilson, FNP BC
• Kayla Windell-Kirk
• Winds of Change Recovery and Mental Health LLC
• William M Wine, DDS

• Occupational Therapist in Beckley, WV
• Providers in Beckley, WV by specialty
• Occupational Therapist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2021; 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.