Rebecca Ann Wade, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OA565 Issued in OK

Practice address

2815 E Jackson St
Hugo, OK 74743-4250

Phone

(580) 326-9200

Fax

(580) 326-8876

NPI assigned

May 21, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346459914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5617 NW 103RD PL",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731626987",
            "telephone_number": "405-550-2092",
            "fax_number": "405-721-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2815 E JACKSON ST",
            "city": "HUGO",
            "state": "OK",
            "postal_code": "747434250",
            "telephone_number": "580-326-9200",
            "fax_number": "580-326-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "REBECCA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "OA565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kashia Nicole Thompson, LMSW
• Joshua Asher Tims, BHRS
• Tricounty Behavioral Health, LLC
• Vision Source of Hugo, Inc.
• Vision Source of Hugo, Inc.
• Victoria Louise Waggoner
• Ruthy M Waight
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0049)
• Tahnee Dianne Waldrum
• Patricia Irene Wallace, LPC,LADC

• Occupational Therapy Assistant in Hugo, OK
• Providers in Hugo, OK by specialty
• Occupational Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.