CAROLYN ANNE WILSON (OTR/L) – Occupational Therapist, NPI 1174415061

CAROLYN ANNE WILSON (OTR/L) is a healthcare provider. based in Windham, Maine. specializing in OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials OTR/L. They hold a License No. OT4846 (ME). The NPI Number for CAROLYN ANNE WILSON (OTR/L) is 1174415061

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
CAROLYN ANNE WILSON (OTR/L)
NPI
1174415061
Phone
(207) 661-2828
Address
584 Roosevelt Trl Unit 2
Enumeration Date
16 July 2025
Last Update Date
28 October 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2076079734
Graduation Year
2025 (1 year ago)
PAC ID
8729582325
Group Practice PAC ID
5395129555
Professional Enrollment ID
I20250917002092
Address ID
ME040112029BR114XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

136 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in ME

Provider Addresses for CAROLYN ANNE WILSON (OTR/L)

  • 584 Roosevelt Trl Unit 2

    Windham, ME 040624983

    Phone: (207) 661-2828

    Fax: (207) 661-2854

    Type: Location

  • 114 Maine St Ste 4

    Brunswick, ME 040112029

    Phone: (207) 607-5800

    Type: Location

  • 119 GANNETT DR

    SOUTH PORTLAND, ME 041066942

    Phone: (207) 773-0040

    Fax: (207) 661-4630

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-09-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250917002092IOccupational Therapist In Private PracticeMETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 04062)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395129555View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeME

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Frequently asked questions

What unique ID ties claims to CAROLYN ANNE WILSON (OTR/L)?
NPI 1174415061 is assigned to CAROLYN ANNE WILSON (OTR/L) under the national enumeration system.
Is CAROLYN ANNE WILSON (OTR/L)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does CAROLYN ANNE WILSON (OTR/L) treat or focus on?
Patients typically see CAROLYN ANNE WILSON (OTR/L) under the specialty Occupational Therapist. Clinical services aligned with this taxonomy classification.
Where does public data place CAROLYN ANNE WILSON (OTR/L)?
The snapshot lists Windham, Maine for CAROLYN ANNE WILSON (OTR/L); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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