NPIMap

Organization Active NPI

Wonderfully Made Pediatric Therapy, LLC

  • Occupational Therapist
  • Laurel, MS
National Provider Identifier
1952213605
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
WONDERFULLY MADE PEDIATRIC THERAPY, LLC
Practice address
12 Northgate Dr
Laurel, MS 39440-2119
Phone
(601) 498-7248
NPI assigned
Sep 18, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Authorized official

Name
Mary SurrettNPI 1861022212
Title
Occupational Therapist
Phone
(601) 498-7248

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225X00000X Primary

Addresses

Primary practice location

12 Northgate Dr
Laurel, MS 39440-2119

Mailing address

12 Northgate Dr
Laurel, MS 39440-2119
Phone (601) 498-7248

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1789689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1789689600000",
    "number": "1952213605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 NORTHGATE DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402119",
            "telephone_number": "601-498-7248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 NORTHGATE DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394402119",
            "telephone_number": "601-498-7248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WONDERFULLY MADE PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-09-18",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A",
        "authorized_official_last_name": "SURRETT",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "601-498-7248"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2026; 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.