Active NPI
Shelley Nicole Wyatt, OTR/L
- Occupational Therapist
- Birmingham, AL
National Provider Identifier
1871861922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2857
- Practice address
- 3057 Lorna Rd Ste 220
Birmingham, AL 35216-4518 - Phone
- (205) 978-9939
- NPI assigned
- Dec 5, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 | 2857 | AL | Primary |
Addresses
Primary practice location
3057 Lorna Rd Ste 220
Birmingham, AL 35216-4518
Mailing address
568 Reach Dr
Birmingham, AL 35242-8646
Phone (205) 253-2887
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2857 | AL | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323043200000",
"number": "1871861922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "568 REACH DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352428646",
"telephone_number": "205-253-2887"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3057 LORNA RD STE 220",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352164518",
"telephone_number": "205-978-9939"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYATT",
"first_name": "SHELLEY",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-05",
"last_updated": "2011-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AL",
"license": "2857",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.