Individual provider Active NPI

Ashlyn Cherie Wisbauer

  • Occupational Therapy Assistant
  • Oklahoma City, OK
National Provider Identifier
1932813623
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2506 Issued in OK
Practice address
901 S Sooner Rd
Oklahoma City, OK 73110-2425
Phone
(405) 610-1909
NPI assigned
Jan 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 2506 OK Primary

Addresses

Primary practice location

901 S Sooner Rd
Oklahoma City, OK 73110-2425

Mailing address

14715 Bristol Park Blvd
Edmond, OK 73013-1894
Phone (405) 840-1686

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

LicenseStateTypeSpecialty
2506OKMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1932813623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14715 BRISTOL PARK BLVD",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131894",
            "telephone_number": "405-840-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S SOONER RD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731102425",
            "telephone_number": "405-610-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISBAUER",
        "first_name": "ASHLYN",
        "middle_name": "CHERIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-09",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "2506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2023; 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.