Individual provider Active NPI

Melissa Wilks, OTR/L

  • Occupational Therapist
  • Newbury, OH
National Provider Identifier
1336642859
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
009215 Issued in OH
Practice address
14775 Auburn Rd
Newbury, OH 44065-9702
Phone
(740) 507-8847
NPI assigned
Mar 11, 2018
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 009215 OH Primary

Addresses

Primary practice location

14775 Auburn Rd
Newbury, OH 44065-9702

Mailing address

16315 Ravenna Rd
Chagrin Falls, OH 44023-9393

Other practice location 1

1956 Red Bird Rd
Madison, OH 44057-2122
Phone (740) 507-8847

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
009215OHMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1520726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1336642859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16315 RAVENNA RD",
            "city": "CHAGRIN FALLS",
            "state": "OH",
            "postal_code": "440239393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14775 AUBURN RD",
            "city": "NEWBURY",
            "state": "OH",
            "postal_code": "440659702",
            "telephone_number": "740-507-8847"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1956 Red Bird Rd",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "OH",
            "postal_code": "440572122",
            "country_code": "US",
            "telephone_number": "740-507-8847",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKS",
        "first_name": "MELISSA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "009215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newbury, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.