Active NPI
Miranda Sue Wiseley, COTA/L
- Occupational Therapy Assistant
- Miami, OK
National Provider Identifier
1881364560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 2190
- Practice address
- 13300 S Highway 125
Miami, OK 74354-5123 - Phone
- (918) 676-6884
- NPI assigned
- Sep 15, 2021
- 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 Therapy Assistant | 224Z00000X | 2190 | OK | Primary |
Addresses
Primary practice location
13300 S Highway 125
Miami, OK 74354-5123
Mailing address
13300 S Highway 125
Miami, OK 74354-5123
Phone (918) 676-6884
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 |
|---|---|---|---|
| 2190 | OK | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631664000000",
"number": "1881364560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13300 S HIGHWAY 125",
"city": "MIAMI",
"state": "OK",
"postal_code": "743545123",
"telephone_number": "918-676-6884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13300 S HIGHWAY 125",
"city": "MIAMI",
"state": "OK",
"postal_code": "743545123",
"telephone_number": "918-676-6884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISELEY",
"first_name": "MIRANDA",
"middle_name": "SUE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-09-15",
"last_updated": "2021-09-15",
"certification_date": "2021-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "OK",
"license": "2190",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Miami, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.