Individual provider Active NPI

Rachel Wanzer, OTA/L

  • Occupational Therapy Assistant
  • Wilmington, NC
National Provider Identifier
1487057022
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
8776 Issued in NC
Practice address
1402 Hospital Plaza Dr
Wilmington, NC 28401-6659
Phone
(910) 591-1857
NPI assigned
Sep 26, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 8776 NC Primary

Addresses

Primary practice location

1402 Hospital Plaza Dr
Wilmington, NC 28401-6659

Mailing address

2620 Northchase Pkwy SE Apt H102
Wilmington, NC 28405-2127
Phone (540) 968-1618

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
8776NCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1411689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1487057022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 NORTHCHASE PKWY SE APT H102",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284052127",
            "telephone_number": "540-968-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 HOSPITAL PLAZA DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016659",
            "telephone_number": "910-591-1857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANZER",
        "first_name": "RACHEL",
        "credential": "OTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-26",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "NC",
            "license": "8776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.