Individual provider Active NPI

Shelly Timms Wilkins, COTA

  • Occupational Therapy Assistant
  • Plano, TX
National Provider Identifier
1326372004
Registry record updated Sep 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
208966 Issued in TX
Practice address
1201 E 15TH St
Suite 304
Plano, TX 75074-6238
Phone
(972) 424-0148
Fax
(972) 422-5275
NPI assigned
Sep 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 208966 TX Primary

Addresses

Primary practice location

1201 E 15TH St
Suite 304
Plano, TX 75074-6238

Mailing address

1201 E 15TH St
Suite 304
Plano, TX 75074-6238
Phone (972) 424-0148

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

LicenseStateTypeSpecialty
208966TXMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254096000000",
    "number": "1326372004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 E 15TH ST",
            "address_2": "SUITE 304",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750746238",
            "telephone_number": "972-424-0148",
            "fax_number": "972-422-5275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E 15TH ST",
            "address_2": "SUITE 304",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750746238",
            "telephone_number": "972-424-0148",
            "fax_number": "972-422-5275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "SHELLY",
        "middle_name": "TIMMS",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-28",
        "last_updated": "2009-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TX",
            "license": "208966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2009; 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.