Active NPI
Ashley P Wilson
- Occupational Therapist
- Canton, GA
National Provider Identifier
1376314369
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT00004620
- Practice address
- 131 Holly St
Canton, GA 30114-9566 - Phone
- (678) 990-5055
- NPI assigned
- Jan 10, 2024
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT00004620 | GA | Primary |
Addresses
Primary practice location
131 Holly St
Canton, GA 30114-9566
Mailing address
1065 Adams Haven BND NW
Acworth, GA 30101-5212
Phone (770) 883-5353
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT00004620 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1704844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1376314369",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1065 ADAMS HAVEN BND NW",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301015212",
"telephone_number": "770-883-5353"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 HOLLY ST",
"city": "CANTON",
"state": "GA",
"postal_code": "301149566",
"telephone_number": "678-990-5055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ASHLEY",
"middle_name": "P",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-01-10",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT00004620",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.