Active NPI
Paulette Audie Marie Wells, COTA
- Occupational Therapy Assistant
- Jenks, OK
National Provider Identifier
1780928341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 1178
- Practice address
- 12095 S Elm St
Jenks, OK 74037-3689 - Phone
- (918) 808-9749
- NPI assigned
- Nov 20, 2012
- Sex
- Female
- Sole proprietor
- No
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 | 1178 | OK | Primary |
Addresses
Primary practice location
12095 S Elm St
Jenks, OK 74037-3689
Mailing address
921 N Fir St
Jenks, OK 74037-2705
Phone (918) 200-4992
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 |
|---|---|---|---|
| 1178 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353369600000",
"number": "1780928341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "921 N FIR ST",
"city": "JENKS",
"state": "OK",
"postal_code": "740372705",
"telephone_number": "918-200-4992"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12095 S ELM ST",
"city": "JENKS",
"state": "OK",
"postal_code": "740373689",
"telephone_number": "918-808-9749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLS",
"first_name": "PAULETTE",
"middle_name": "AUDIE MARIE",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-20",
"last_updated": "2012-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OK",
"license": "1178",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jenks, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.