Active NPI
Laura Hicks Wilkinson
- Occupational Therapist
- Brooks, GA
National Provider Identifier
1962943621
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT000812
- Practice address
- 130 Dukes CT
Brooks, GA 30205-1643 - Phone
- (770) 716-0099
- NPI assigned
- Mar 14, 2017
- Last updated
- Mar 14, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT000812 | GA | Primary |
Addresses
Primary practice location
130 Dukes CT
Brooks, GA 30205-1643
Mailing address
130 Dukes CT
Brooks, GA 30205-1643
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OT000812 | GA | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489449600000",
"number": "1962943621",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 DUKES CT",
"city": "BROOKS",
"state": "GA",
"postal_code": "302051643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 DUKES CT",
"city": "BROOKS",
"state": "GA",
"postal_code": "302051643",
"telephone_number": "770-716-0099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKINSON",
"first_name": "LAURA",
"middle_name": "HICKS",
"name_prefix": "Mrs.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-14",
"last_updated": "2017-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "GA",
"license": "OT000812",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooks, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.