Individual provider Active NPI

Amber Jonell Wydner, OTR/L

  • Occupational Therapist
  • Roswell, GA
National Provider Identifier
1639342371
Registry record updated Apr 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
3616 Issued in GA
Practice address
11350 Woodstock Rd
Roswell, GA 30075-7541
Phone
(678) 585-9191
NPI assigned
Apr 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 3616 GA Primary

Addresses

Primary practice location

11350 Woodstock Rd
Roswell, GA 30075-7541

Mailing address

11350 Woodstock Rd
Roswell, GA 30075-7541

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3616GAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Orthopaedic Center PastSince Nov 22, 2004 Accepting new patients
HH Health System - the Orthopaedic Center, LLC PastSince Aug 13, 2023 Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/fca878a1-6c97-4ecb-b6e7-eb5d7cde15ab/

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207180800000",
    "number": "1639342371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 WOODSTOCK RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300757541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11350 WOODSTOCK RD",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300757541",
            "telephone_number": "678-585-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYDNER",
        "first_name": "AMBER",
        "middle_name": "JONELL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2008-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "3616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; 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.