Individual provider Active NPI

Devon Christine Wilson, OTR/L

  • Occupational Therapist
  • Newport News, VA
National Provider Identifier
1700637311
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119010338 Issued in VA
Practice address
11832 Rock Landing Dr Ste 105
Newport News, VA 23606-4261
Phone
(757) 455-5000
NPI assigned
Apr 1, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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 0119010338 VA Primary

Addresses

Primary practice location

11832 Rock Landing Dr Ste 105
Newport News, VA 23606-4261

Mailing address

11832 Rock Landing Dr Ste 105
Newport News, VA 23606-4261
Phone (757) 455-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240501001753 VA Practitioner - Occupational Therapist in Private Practice 5597105080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
JP Therapy LLCGroup PAC ID 6709192503, 28 clinicians

Practice addresses (Care Compare)

5604 Virginia Beach Blvd
Suite 101
Virginia Beach, VA 23462-5631
Phone (757) 455-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119010338VAMDOccupational Therapist

Organizations & group practices 1

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": "1711929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1700637311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11832 ROCK LANDING DR STE 105",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064261",
            "telephone_number": "757-455-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11832 ROCK LANDING DR STE 105",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236064261",
            "telephone_number": "757-455-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DEVON",
        "middle_name": "CHRISTINE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-01",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119010338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.