Active NPI
Laila Wahid
- Occupational Therapist
- Saint Marys, GA
National Provider Identifier
1982195780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT19208
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| OT19208 | FL | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advance for Kids Inc | Occupational Therapist | Past | 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.