Active NPI
Ramona Diane Wiedemann
- Occupational Therapist
- Tullahoma, TN
National Provider Identifier
1619352986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1387
- Practice address
- 2110 N Jackson St
Tullahoma, TN 37388-2208 - Phone
- (931) 455-5189
- Fax
- (931) 393-2455
- NPI assigned
- Jul 28, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1387 | TN | Primary |
Addresses
Primary practice location
2110 N Jackson St
Tullahoma, TN 37388-2208
Mailing address
2110 N Jackson St
Tullahoma, TN 37388-2208
Phone (931) 455-5189
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 |
|---|---|---|---|
| 1387 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Top Rehab Services, Inc. | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1438041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438041600000",
"number": "1619352986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 N JACKSON ST",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "373882208",
"telephone_number": "931-455-5189",
"fax_number": "931-393-2455"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 N JACKSON ST",
"city": "TULLAHOMA",
"state": "TN",
"postal_code": "373882208",
"telephone_number": "931-455-5189",
"fax_number": "931-393-2455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEDEMANN",
"first_name": "RAMONA",
"middle_name": "DIANE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-28",
"last_updated": "2015-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "1387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tullahoma, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 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.