Stephanie Wildermuth, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

16-1316 Issued in NV

Practice address

10401 W Charleston Blvd
Las Vegas, NV 89135-1151

Phone

(702) 207-4229

NPI assigned

Feb 28, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551312000000",
    "number": "1902363658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10401 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351151",
            "telephone_number": "702-207-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10401 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891351151",
            "telephone_number": "702-207-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDERMUTH",
        "first_name": "STEPHANIE",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2019-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "NV",
            "license": "16-1316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chanel Wilder
• Kari Linn Wilder
• Mary Ann Wilder, RNC, MSN, C-APN
• Tammy Wilder
• Lilith Wildermuth
• Curtis Wildes, MS, ATC, CSCS, PES
• Melissa Wildey
• Patricia Wildey
• Wildflower Therapy Services, LLC
• Danielle Wildharber

• Occupational Therapy Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Occupational Therapy Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.