Jeffrey W Wickline, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

9721 Issued in NC

Practice address

3260 Oceanic Bay Dr
Southport, NC 28461-6401

Phone

(203) 217-9366

NPI assigned

Jul 14, 2014

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Integrated Pediatric Therapies

  • Physical Medicine & Rehabilitation Physician
  • Whiteville, NC
  • NPI 1013426980

  Occupational Therapist

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1760899686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 MATTEO DRIVE",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284121000",
            "telephone_number": "203-217-9366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3260 OCEANIC BAY DR",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284616401",
            "telephone_number": "203-217-9366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLINE",
        "first_name": "JEFFREY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-07-14",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CT",
            "license": "001758",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "9721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marybeth Weinacht, PT
• James Keller Weingarten, M.D.
• Larry Felix Weisner, MD
• Amy Elizabeth Weisse, DPT
• Victoria Wessell, OTR/L
• Jennifer S. Williams, DDS
• Leonard David Williams IV, D.D.S.
• Wilmington Health PLLC
• Wilmington Orthopaedic Group
• Steven Douglas Wilson, MD

• Occupational Therapist in Southport, NC
• Providers in Southport, NC by specialty
• Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.