Tracy Wilson

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

03971 Issued in MD

Practice address

2422 Saint George Way
Brookeville, MD 20833-3265

Phone

(301) 570-8415

Fax

(301) 570-8415

NPI assigned

Dec 26, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Els for Autism Foundation

  • Behavior Analyst
  • Jupiter, FL
  • NPI 1336522515

  Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1167091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790840296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2422 SAINT GEORGE WAY",
            "city": "BROOKEVILLE",
            "state": "MD",
            "postal_code": "208333265",
            "telephone_number": "301-570-8415",
            "fax_number": "301-570-8415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2422 SAINT GEORGE WAY",
            "city": "BROOKEVILLE",
            "state": "MD",
            "postal_code": "208333265",
            "telephone_number": "301-570-8415",
            "fax_number": "301-570-8415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TRACY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "03971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "J917-0001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arielle Vil, NP
• Tamdan Vodinh, D.D.S
• Amy Dilweg Wenhold
• Karen Camille Williams, PHARMD
• Nancy Vollmer Wilson
• Helena Yoo, MD

• Occupational Therapist in Brookeville, MD
• Providers in Brookeville, MD by specialty
• Occupational Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.