Active NPI
Rebecca Wickizer, OTR/L
- Occupational Therapist
- Tulsa, OK
National Provider Identifier
1417341082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1955
- 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, 2015
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 0004236 | CO | MD | Pharmacy Technician |
| 0119006285 | VA | MD | Occupational Therapist |
| 1955 | OK | MD | Physician 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.