Individual provider Active NPI

Tammi M Wilham, OT

  • Occupational Therapist
  • Albuquerque, NM
National Provider Identifier
1861429441
Registry record updated Apr 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2113 Issued in NM
Practice address
1010 Lead Ave SE
Albuquerque, NM 87106-5214
Phone
(505) 724-4300
Fax
(505) 724-4384
NPI assigned
Jun 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2113 NM Primary

Addresses

Primary practice location

1010 Lead Ave SE
Albuquerque, NM 87106-5214

Mailing address

201 Cedar St SE
Suite 6600
Albuquerque, NM 87106-4917
Phone (505) 724-4300

Other identifiers 1

IdentifierTypeStateIssuer
60030771MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060927000494 NM Practitioner - Occupational Therapist in Private Practice 3274538152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Mexico Orthopaedic Associates PCGroup PAC ID 1759270713, 74 clinicians

Practice addresses (Care Compare)

2101 Unser Blvd SE
Nmo Rio Rancho Clinic
Rio Rancho, NM 87124-6378
Phone (505) 724-4700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2113NMMDOccupational Therapist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366761600000",
    "number": "1861429441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 CEDAR ST SE",
            "address_2": "SUITE 6600",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064917",
            "telephone_number": "505-724-4300",
            "fax_number": "505-724-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 LEAD AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871065214",
            "telephone_number": "505-724-4300",
            "fax_number": "505-724-4384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILHAM",
        "first_name": "TAMMI",
        "middle_name": "M",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-27",
        "last_updated": "2013-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "2113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60030771",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.