Nanette Wilde, OTR

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

113768 Issued in TX

Practice address

1102 Winkler Ave
Killeen, TX 76542

Phone

(254) 634-8505

Fax

(254) 781-4312

NPI assigned

Mar 30, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11823/brand/2/csg/41/fhir/r4

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.

• Barr Physical Therapy, P.C.

  • Speech-Language Pathologist
  • Killeen, TX
  • NPI 1063769685

  Occupational Therapist

  NPD (past)
• Barr Physical Therapy, P.C.

  • Pediatric Physical Therapist
  • Killeen, TX
  • NPI 1306927553

  Occupational Therapist

  NPD (past)
• San Luis Walk-in Clinic, Inc.

  • Rural Health Clinic/Center
  • Somerton, AZ
  • NPI 1003991506
  NPD (past)

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1770859019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 DONNIE AVE",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765418918",
            "telephone_number": "254-634-8505",
            "fax_number": "254-781-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 WINKLER AVE",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "76542",
            "telephone_number": "254-634-8505",
            "fax_number": "254-781-4312"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 S A W Grimes Blvd",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786647429",
            "country_code": "US",
            "telephone_number": "512-310-7665",
            "fax_number": "512-310-9228",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDE",
        "first_name": "NANETTE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-30",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "113768",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "113768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0031DG",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0944746-02",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Helen Suzanne Whitlock, OTR
• Tabetha Nicole Wiggins
• Ashley Wilbanks, RBT
• James Carson Wilcox II, CRNA
• Kendall Wild, MS, CFY/SLP
• Natasha Lee Wilhite, APRN-CNP
• Rowan Sky Wilkerson
• William S Marsh III, DO, PA
• Jasmine Williams-Purcell, LABA
• Alicia Williams, NP

• Pediatric Occupational Therapist in Killeen, TX
• Providers in Killeen, TX by specialty
• Pediatric Occupational Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.