Tracy Wilson

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

03971 Issued in MD

Legal business name

TRACY WILSON

Practice address

17620 Redland Rd Ste a
Rockville, MD 20855-1245

Phone

(301) 869-7505

Fax

(301) 869-7515

NPI assigned

Apr 29, 2013

Organization subpart

No

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

Authorized official

Name

Mrs. Tracy Wilson, MS, OTR/L

Title

Owner/Occupational Therapist

Phone

(301) 869-7505

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1367193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367193600000",
    "number": "1902240385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17620 REDLAND RD STE A",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208551245",
            "telephone_number": "301-869-7505",
            "fax_number": "301-869-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17620 REDLAND RD STE A",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208551245",
            "telephone_number": "301-869-7505",
            "fax_number": "301-869-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY WILSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-29",
        "last_updated": "2013-04-29",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "OWNER/OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "301-869-7505",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS, OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MD",
            "license": "03971",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Occupational Therapist in Rockville, MD
• Providers in Rockville, MD by specialty
• Pediatric Occupational Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; 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.