Individual provider Active NPI

Leigh Kristin Wixted, COTA/L

  • Occupational Therapy Assistant
  • Sanford, FL
National Provider Identifier
1528745882
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
OTA19160 Issued in FL
Practice address
5433 W State Road 46
Sanford, FL 32771-9236
Phone
(407) 322-2207
NPI assigned
Jun 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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 OTA19160 FL Primary

Addresses

Primary practice location

5433 W State Road 46
Sanford, FL 32771-9236

Mailing address

111 W Highbanks Rd
Debary, FL 32713-2844
Phone (386) 228-7199

Other practice location 1

111 W Highbanks Rd
Debary, FL 32713-2844
Phone (386) 228-7199

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
OTA19160FLMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1528745882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W HIGHBANKS RD",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132844",
            "telephone_number": "386-228-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5433 W STATE ROAD 46",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327719236",
            "telephone_number": "407-322-2207"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 W Highbanks Rd",
            "address_purpose": "LOCATION",
            "city": "Debary",
            "state": "FL",
            "postal_code": "327132844",
            "country_code": "US",
            "telephone_number": "386-228-7199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIXTED",
        "first_name": "LEIGH",
        "middle_name": "KRISTIN",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-29",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "FL",
            "license": "OTA19160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.