Active NPI
Regina Wilson
- Occupational Therapist
- Philadelphia, PA
National Provider Identifier
1811400732
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OC015317
- Practice address
- 160 E Erie Ave
Philadelphia, PA 19134-1011 - Phone
- (215) 427-5000
- NPI assigned
- Nov 14, 2017
- Last updated
- Mar 21, 2023
- 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 Therapist | 225X00000X | OC015317 | PA | Primary |
Addresses
Primary practice location
160 E Erie Ave
Philadelphia, PA 19134-1011
Mailing address
PO Box 13579
Reading, PA 19612-3579
Phone (484) 628-1324
Other practice location 1
16 S State St
Newtown, PA 18940-1963
Phone (215) 550-6109
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OC015317 | PA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510617600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679356800000",
"number": "1811400732",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 13579",
"city": "READING",
"state": "PA",
"postal_code": "196123579",
"telephone_number": "484-628-1324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "160 E ERIE AVE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191341011",
"telephone_number": "215-427-5000"
}
],
"practiceLocations": [
{
"address_1": "16 S State St",
"address_purpose": "LOCATION",
"city": "Newtown",
"state": "PA",
"postal_code": "189401963",
"country_code": "US",
"telephone_number": "215-550-6109",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "REGINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-14",
"last_updated": "2023-03-21",
"certification_date": "2021-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "PA",
"license": "OC015317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.