Individual provider Active NPI

Aleisha Diane Wilson, COTA/L

  • Occupational Therapy Assistant
  • Maryville, TN
National Provider Identifier
1619431103
Registry record updated Jan 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2420 Issued in TN
Practice address
2320 E Lamar Alexander Pkwy
Maryville, TN 37804-5316
Phone
(865) 273-8323
NPI assigned
Jan 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2019

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 2420 TN Primary

Addresses

Primary practice location

2320 E Lamar Alexander Pkwy
Maryville, TN 37804-5316

Mailing address

2320 E Lamar Alexander Pkwy
Maryville, TN 37804-5316

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

NPI Registry JSON

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1619431103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 E LAMAR ALEXANDER PKWY",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045316",
            "telephone_number": "865-273-8323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALEISHA",
        "middle_name": "DIANE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "2420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.