Joanna Nilssen, O.T.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

020889 Issued in NY

Practice address

4112 Outlook Blvd Ste 96
Pueblo, CO 81008-1667

Phone

(719) 562-6200

Fax

(719) 562-6225

NPI assigned

Sep 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Joanna Wilkinson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1473379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1922555762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2142 UTOPIA PKWY",
            "city": "WHITESTONE",
            "state": "NY",
            "postal_code": "113574142",
            "telephone_number": "718-819-6805",
            "fax_number": "347-841-9109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD STE 96",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "719-562-6200",
            "fax_number": "719-562-6225"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1733 N Ocean Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NY",
            "postal_code": "117632606",
            "country_code": "US",
            "telephone_number": "631-207-3600",
            "fax_number": "631-207-2300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NILSSEN",
        "first_name": "JOANNA",
        "credential": "O.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-09",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "020889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOANNA",
            "last_name": "WILKINSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Occupational Therapist in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Occupational Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.