Active NPI
Juanita Wilkerson
- Developmental Therapist
- Pompano Beach, FL
National Provider Identifier
1972842672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental Therapist
- License
- T60-20-4979
- Practice address
- 4301 N Federal Hwy
Suite 2 South
Pompano Beach, FL 33064-6519 - Phone
- (888) 880-9270
- Fax
- (954) 342-0273
- NPI assigned
- Jan 31, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | T60-20-4979 | VA | Primary |
Addresses
Primary practice location
4301 N Federal Hwy
Suite 2 South
Pompano Beach, FL 33064-6519
Mailing address
310 Piez Ave
Newport News, VA 23601-4020
Phone (757) 619-8049
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1359590400000",
"number": "1972842672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "310 PIEZ AVE",
"city": "NEWPORT NEWS",
"state": "VA",
"postal_code": "236014020",
"telephone_number": "757-619-8049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 N FEDERAL HWY",
"address_2": "SUITE 2 SOUTH",
"city": "POMPANO BEACH",
"state": "FL",
"postal_code": "330646519",
"telephone_number": "888-880-9270",
"fax_number": "954-342-0273"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKERSON",
"first_name": "JUANITA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-31",
"last_updated": "2013-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": "VA",
"license": "T60-20-4979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pompano Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.