Shadera Wiginton, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1417 Issued in OK

Practice address

3801 24TH Ave SE Apt 12
Norman, OK 73071-0800

Phone

(405) 596-7148

NPI assigned

Apr 29, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1841873692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 24TH AVE SE APT 12",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730710800",
            "telephone_number": "405-596-7148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 24TH AVE SE APT 12",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730710800",
            "telephone_number": "405-596-7148"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8200 S Walker Ave",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731399452",
            "country_code": "US",
            "telephone_number": "405-297-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIGINTON",
        "first_name": "SHADERA",
        "name_prefix": "Mrs.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "1417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "shaderawigintonpta@gmail.com",
            "affiliation": "N",
            "address_1": "3801 24th Ave SE Apt 12",
            "city": "Norman",
            "state": "OK",
            "country_code": "US",
            "postal_code": "730710800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wickshire Norman Opco LLC
• Christopher Chase Widman
• Andria Wiederhoeft
• Elise R Wiesner, MD
• Nicholas Wight
• Angela Michelle Wilbourn
• Carmen A Wilcox, P.T
• Cynthia D. Wilcox, RD, LD
• Jeremy Wilcox
• Amy Wilder, M.S., SLP

• Physical Therapy Assistant in Norman, OK
• Providers in Norman, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.