Individual provider Active NPI

Rebecca Wickizer, OTR/L

  • Occupational Therapist
  • Tulsa, OK
National Provider Identifier
1417341082
Registry record updated Mar 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1955 Issued in OK
Practice address
5800 E Skelly Dr
Suite 402
Tulsa, OK 74135-6471
Phone
(918) 351-4596
NPI assigned
Mar 22, 2015
Last updated
Mar 22, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2015

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 1955 OK Primary
Occupational Therapist 225X00000X 0119006285 VA
Occupational Therapist 225X00000X 0004236 CO

Addresses

Primary practice location

5800 E Skelly Dr
Suite 402
Tulsa, OK 74135-6471

Mailing address

5800 E Skelly Dr
Suite 402
Tulsa, OK 74135-6471

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
0004236COMDPharmacy Technician
0119006285VAMDOccupational Therapist
1955OKMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1426982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426982400000",
    "number": "1417341082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5800 E SKELLY DR",
            "address_2": "SUITE 402",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 E SKELLY DR",
            "address_2": "SUITE 402",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356471",
            "telephone_number": "918-351-4596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKIZER",
        "first_name": "REBECCA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-22",
        "last_updated": "2015-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OK",
            "license": "1955",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119006285",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "0004236",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2015; 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.