Active NPI
Alexander A Wilson, MS, OTR/L
- Occupational Therapist
- Jamaica Plain, MA
National Provider Identifier
1720218811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 9861
- Practice address
- 91 Moraine St
Jamaica Plain, MA 02130-4329 - Phone
- (303) 669-8863
- NPI assigned
- Jul 23, 2009
- Sex
- Male
- 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 Therapist | 225X00000X | 9861 | MA | Primary |
Addresses
Primary practice location
91 Moraine St
Jamaica Plain, MA 02130-4329
Mailing address
91 Moraine St
Jamaica Plain, MA 02130-4329
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 251638 | Other | NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9861 | MA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248307200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248307200000",
"number": "1720218811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "91 MORAINE ST",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021304329"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "91 MORAINE ST",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021304329",
"telephone_number": "303-669-8863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ALEXANDER",
"middle_name": "A",
"credential": "MS, OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-23",
"last_updated": "2009-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "9861",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NATIONAL BOARD FOR CERTIFICATION IN OCCUPATIONAL THERAPY",
"identifier": "251638",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.