Raegan Willis, COTA
Individual provider Active NPI Occupational Therapy Assistant · White Pine, TN
NPI 1669327953 · NPPES record last updated Mar 2, 2026
Key facts
- NPI
- 1669327953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapy Assistant 224Z00000X
- License
- 4297 (TN)
- Practice address
- 407 Laura Lee Dr
White Pine, TN 37890-3500 - Phone
- (865) 327-4100
- NPI assigned
- Mar 2, 2026
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4297 | TN | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 4297 | TN | Yes |
Addresses
Primary practice location
407 Laura Lee Dr
White Pine, TN 37890-3500
Mailing address
3334 Frank Morie Rd
White Pine, TN 37890-4504
Phone (865) 839-0623
Other practice location 1
914 Industrial Park Rd
Dandridge, TN 37725-4700
Phone (865) 397-3163
Other providers in White Pine, TN
- James B Schindler
- Southerrn Home Infusion Pharmacy
- Melissa N Thompson
- Shannon Wallace
- Wesley T Cowan
All providers in White Pine, TN · Occupational Therapy Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.