Active NPI
Alecia Wyrick, COTA
- Occupational Therapy Assistant
- Durant, OK
National Provider Identifier
1639280563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 207948
- Practice address
- 1100 Oakridge Dr
Durant, OK 74701-2620 - Phone
- (580) 924-8579
- Fax
- (580) 745-9357
- NPI assigned
- Aug 31, 2006
- 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 Therapy Assistant | 224Z00000X | 207948 | TX | Primary |
Addresses
Primary practice location
1100 Oakridge Dr
Durant, OK 74701-2620
Mailing address
PO Box 831
Madill, OK 73446-0831
Phone (580) 795-3301
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 |
|---|---|---|---|
| 207948 | TX | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639280563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 831",
"city": "MADILL",
"state": "OK",
"postal_code": "734460831",
"telephone_number": "580-795-3301",
"fax_number": "580-795-7307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 OAKRIDGE DR",
"city": "DURANT",
"state": "OK",
"postal_code": "747012620",
"telephone_number": "580-924-8579",
"fax_number": "580-745-9357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYRICK",
"first_name": "ALECIA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "TX",
"license": "207948",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Durant, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.