Active NPI
Joseph Robert Wymore, OTR/L
- Occupational Therapist
- Alexandria, MN
National Provider Identifier
1841987435
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 105623
- Practice address
- 420 12TH Ave E
Alexandria, MN 56308-2612 - Phone
- (320) 335-8697
- NPI assigned
- Apr 24, 2023
- Sex
- Male
- 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 | 105623 | MN | Primary |
Addresses
Primary practice location
420 12TH Ave E
Alexandria, MN 56308-2612
Mailing address
1202 S Le Homme Dieu Dr NE
Alexandria, MN 56308-7600
Phone (320) 304-4086
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682294400000",
"number": "1841987435",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1202 S LE HOMME DIEU DR NE",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563087600",
"telephone_number": "320-304-4086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "420 12TH AVE E",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563082612",
"telephone_number": "320-335-8697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYMORE",
"first_name": "JOSEPH",
"middle_name": "ROBERT",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-04-24",
"last_updated": "2023-04-24",
"certification_date": "2023-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "105623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.