Active NPI
Stacey Ann Wilks, OTR/L
- Occupational Therapist
- White Plains, NY
National Provider Identifier
1649465709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 011953-1
- Practice address
- 33 Maplemoor LN
White Plains, NY 10605-4716 - Phone
- (347) 512-2785
- NPI assigned
- Sep 12, 2007
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 011953-1 | NY | |
| Driving and Community Mobility Occupational Therapist | 225XR0403X | 011953-1 | NY | |
| Occupational Therapist | 225X00000X | 011953-1 | NY | Primary |
Addresses
Primary practice location
33 Maplemoor LN
White Plains, NY 10605-4716
Mailing address
16 North Broadway Apt 2B
White Plains, NY 10601
Phone (347) 512-2785
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 |
|---|---|---|---|
| 011953-1 | NY | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189555200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712880000000",
"number": "1649465709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 NORTH BROADWAY APT 2B",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "10601",
"telephone_number": "347-512-2785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 MAPLEMOOR LN",
"city": "WHITE PLAINS",
"state": "NY",
"postal_code": "106054716",
"telephone_number": "347-512-2785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKS",
"first_name": "STACEY",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-12",
"last_updated": "2024-04-12",
"certification_date": "2024-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "NY",
"license": "011953-1",
"primary": false
},
{
"code": "225XR0403X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Driving and Community Mobility",
"state": "NY",
"license": "011953-1",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "011953-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in White Plains, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.