Individual provider Active NPI

Laila Wahid

  • Occupational Therapist
  • Saint Marys, GA
National Provider Identifier
1982195780
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT19208 Issued in FL
Practice address
70 Lindsey LN
Saint Marys, GA 31558-1635
Phone
(912) 510-6104
Fax
(912) 882-6137
NPI assigned
May 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT19208 FL Primary

Addresses

Primary practice location

70 Lindsey LN
Saint Marys, GA 31558-1635

Mailing address

11770 Lanier Creek Dr
Jacksonville, FL 32258-1262

Other practice location 1

11770 Lanier Creek Dr
Jacksonville, FL 32258-1262
Phone (904) 207-8511

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
OT19208FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advance for Kids Inc Occupational Therapist PastSince Mar 11, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1982195780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11770 LANIER CREEK DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322581262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 LINDSEY LN",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315581635",
            "telephone_number": "912-510-6104",
            "fax_number": "912-882-6137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11770 Lanier Creek Dr",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322581262",
            "country_code": "US",
            "telephone_number": "904-207-8511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAHID",
        "first_name": "LAILA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-29",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT19208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.