Active NPI
Karen Wiley, COTA
- Occupational Therapy Assistant
- Las Vegas, NV
National Provider Identifier
1669766903
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1199
- Practice address
- 2075 E Flamingo Rd Ste 114
Las Vegas, NV 89119-5188 - Phone
- (702) 866-2098
- Fax
- (702) 866-2062
- NPI assigned
- Jun 3, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 1199 | NV | Primary |
Addresses
Primary practice location
2075 E Flamingo Rd Ste 114
Las Vegas, NV 89119-5188
Mailing address
1680 Turf Dr
Henderson, NV 89002-9322
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1057898 | Other | NBCOT |
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 |
|---|---|---|---|
| 1199 | NV | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307059200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307059200000",
"number": "1669766903",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1680 TURF DR",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890029322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2075 E FLAMINGO RD STE 114",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891195188",
"telephone_number": "702-866-2098",
"fax_number": "702-866-2062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "KAREN",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-03",
"last_updated": "2011-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NV",
"license": "1199",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NBCOT",
"identifier": "1057898",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.