Active NPI
Jaimie Leigh Wardlaw, OTA/L
- Environmental Modification Occupational Therapy Assistant
- Oklahoma City, OK
National Provider Identifier
1275966194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Environmental Modification Occupational Therapy Assistant
- License
- 1233
- Practice address
- 7617 NW 133Rd PL
Oklahoma City, OK 73142-4451 - Phone
- (405) 206-1242
- NPI assigned
- Aug 14, 2013
- 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 |
|---|---|---|---|---|
| Environmental Modification Occupational Therapy Assistant | 224ZE0001X | 1233 | OK | Primary |
Addresses
Primary practice location
7617 NW 133Rd PL
Oklahoma City, OK 73142-4451
Mailing address
521 N 2ND St
Okeene, OK 73763-9369
Phone (580) 822-1585
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 |
|---|---|---|---|
| 1233 | OK | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435708800000",
"number": "1275966194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "521 N 2ND ST",
"city": "OKEENE",
"state": "OK",
"postal_code": "737639369",
"telephone_number": "580-822-1585"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7617 NW 133RD PL",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731424451",
"telephone_number": "405-206-1242"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARDLAW",
"first_name": "JAIMIE",
"middle_name": "LEIGH",
"name_prefix": "Mrs.",
"credential": "OTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-08-14",
"last_updated": "2015-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "224ZE0001X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant, Environmental Modification",
"state": "OK",
"license": "1233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.