Individual provider Active NPI

Otis Wilkins

  • Non-emergency Medical Transport (VAN)
  • Memphis, TN
National Provider Identifier
1467901447
Registry record updated Oct 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
066801535 Issued in TN
Practice address
4286 University St
Memphis, TN 38127-3559
Phone
(901) 210-6972
NPI assigned
Oct 1, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 066801535 TN Primary

Addresses

Primary practice location

4286 University St
Memphis, TN 38127-3559

Mailing address

4286 University St
Memphis, TN 38127-3559
Phone (901) 210-6972

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
066801535TNMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1475280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475280000000",
    "number": "1467901447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4286 UNIVERSITY ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381273559",
            "telephone_number": "901-210-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4286 UNIVERSITY ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381273559",
            "telephone_number": "901-210-6972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "OTIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-01",
        "last_updated": "2016-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "TN",
            "license": "066801535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2016; 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.