Active NPI
Wanda Jean Chiscolm, COTA/L
- Occupational Therapy Assistant
- Las Vegas, NV
National Provider Identifier
1285914515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1079
- Practice address
- 6351 N. Fort Apache Rd.
Las Vegas, NV 89149 - Phone
- (702) 686-6469
- Fax
- (971) 206-5203
- NPI assigned
- Aug 17, 2011
- 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 Therapy Assistant | 224Z00000X | 1079 | NV | Primary |
Addresses
Primary practice location
6351 N. Fort Apache Rd.
Las Vegas, NV 89149
Mailing address
4560 SE International Way
Ste. 100
Milwaukie, OR 97222
Phone (971) 206-5200
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1345075200000",
"number": "1285914515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4560 SE INTERNATIONAL WAY",
"address_2": "STE. 100",
"city": "MILWAUKIE",
"state": "OR",
"postal_code": "97222",
"telephone_number": "971-206-5200",
"fax_number": "971-206-5203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6351 N. FORT APACHE RD.",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89149",
"telephone_number": "702-686-6469",
"fax_number": "971-206-5203"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHISCOLM",
"first_name": "WANDA",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-17",
"last_updated": "2012-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NV",
"license": "1079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.