Active NPI
Wykeia Monique Sanders, COTA
- Occupational Therapy Assistant
- Gallup, NM
National Provider Identifier
1467934646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 4279
- Practice address
- 306 E Nizhoni Blvd
Gallup, NM 87301-5794 - Phone
- (505) 863-9551
- NPI assigned
- Sep 4, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 214349 | TX | |
| Occupational Therapy Assistant | 224Z00000X | 4279 | NM | Primary |
Addresses
Primary practice location
306 E Nizhoni Blvd
Gallup, NM 87301-5794
Mailing address
586 Penal Farm Rd
Sibley, LA 71073-3053
Phone (318) 834-6222
Other practice location 1
3921 N Main St
Baytown, TX 77521-3307
Phone (281) 422-9541
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 |
|---|---|---|---|
| 214349 | TX | MD | Occupational Therapy Assistant |
| 4279 | NM | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625184000000",
"number": "1467934646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "586 PENAL FARM RD",
"city": "SIBLEY",
"state": "LA",
"postal_code": "710733053",
"telephone_number": "318-834-6222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "306 E NIZHONI BLVD",
"city": "GALLUP",
"state": "NM",
"postal_code": "873015794",
"telephone_number": "505-863-9551"
}
],
"practiceLocations": [
{
"address_1": "3921 N Main St",
"address_purpose": "LOCATION",
"city": "Baytown",
"state": "TX",
"postal_code": "775213307",
"country_code": "US",
"telephone_number": "281-422-9541",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANDERS",
"first_name": "WYKEIA",
"middle_name": "MONIQUE",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-04",
"last_updated": "2021-07-02",
"certification_date": "2021-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "214349",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NM",
"license": "4279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gallup, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.