Active NPI
Bre'Anna Monique Wilson, OTR
- Occupational Therapist
- Austin, TX
National Provider Identifier
1972129492
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 118216
- Practice address
- 4800 Steiner Ranch Blvd Apt 21201
Austin, TX 78732-2561 - Phone
- (979) 484-9499
- NPI assigned
- Jun 20, 2020
- 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 | 118216 | TX | Primary |
Addresses
Primary practice location
4800 Steiner Ranch Blvd Apt 21201
Austin, TX 78732-2561
Mailing address
4800 Steiner Ranch Blvd Apt 21201
Austin, TX 78732-2561
Phone (979) 484-9499
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 |
|---|---|---|---|
| 118216 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1638316800000",
"number": "1972129492",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4800 STEINER RANCH BLVD APT 21201",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787322561",
"telephone_number": "979-484-9499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 STEINER RANCH BLVD APT 21201",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787322561",
"telephone_number": "979-484-9499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "BRE'ANNA",
"middle_name": "MONIQUE",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-20",
"last_updated": "2021-12-01",
"certification_date": "2021-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "118216",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.