Laura Wiley, O.T.

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

OT003110 Issued in GA

Practice address

6478 Putnam Ford Dr Ste 124
Woodstock, GA 30189-6987

Phone

(404) 234-1370

NPI assigned

Oct 2, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Simply Play LLC

  • Occupational Therapist
  • Woodstock, GA
  • NPI 1124661004
  Authorized official Same address or phone
• Magnolia Rehab Services

  • Speech-Language Pathologist
  • Panama City, FL
  • NPI 1427072370

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1275626459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 SIXES RD STE 126-235",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301148192",
            "telephone_number": "404-234-1370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6478 PUTNAM FORD DR STE 124",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301896987",
            "telephone_number": "404-234-1370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3565 Austell Rd SW",
            "address_2": "Suite # 11",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300085769",
            "country_code": "US",
            "telephone_number": "770-319-8000",
            "fax_number": "770-319-8730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3760 Sixes Rd Ste 126-235",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "GA",
            "postal_code": "301148192",
            "country_code": "US",
            "telephone_number": "404-234-1370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "LAURA",
        "credential": "O.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT003110",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT003110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000948645B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000948648B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anne M Whitney, LCSW
• Bram Wieskopf, MD
• Cydney Wilbanks, PA-C
• Jacob Wilbur, PT, DPT
• Rachel Deonna Wiles, MS, OTR/L
• Krisha Wilkins, LPN
• Tyeisha Williams-Mills, LCSW
• David John Williams, D.C.
• Jacara Williams
• Kennedy Williams

• Pediatric Occupational Therapist in Woodstock, GA
• Providers in Woodstock, GA by specialty
• Pediatric Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.