Lacy Nowicki, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

719-26 Issued in WI

Practice address

10222 74TH St Ste 211
Kenosha, WI 53142-6810

Phone

(262) 925-5020

NPI assigned

Jan 21, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Rehabilitation Services Wi LLC 144 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Fox Rehabilitation Services Wi LLC

  • Physical Therapist
  • Milwaukee, WI
  • NPI 1518483973

  Occupational Therapist, WI

  Medicare reassignment Care Compare group NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Burlington, WI
  • NPI 1881773463

  WI

  Medicare reassignment NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Pleasant Prairie, WI
  • NPI 1104497015
  NPD
• Advantage Physical Therapy & Sports Rehab, LLC

  • Rehabilitation Clinic/Center
  • Hayward, WI
  • NPI 1902556012
  NPD

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1013507201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 W TYVOLA RD STE 350",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282174574",
            "telephone_number": "419-221-3004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10222 74TH ST STE 211",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531426810",
            "telephone_number": "262-925-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "W180N8071 Town Hall Rd",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530513518",
            "country_code": "US",
            "telephone_number": "262-253-2700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9047 W Greenfield Ave",
            "address_purpose": "LOCATION",
            "city": "West Allis",
            "state": "WI",
            "postal_code": "532142800",
            "country_code": "US",
            "telephone_number": "414-453-9290",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "425 N University Dr",
            "address_purpose": "LOCATION",
            "city": "Waukesha",
            "state": "WI",
            "postal_code": "531883174",
            "country_code": "US",
            "telephone_number": "262-524-6400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOWICKI",
        "first_name": "LACY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "719-26",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7219-26",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lnowicki@corahealth.com",
            "affiliation": "N",
            "endpointDescription": "work email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "medical",
            "address_1": "10222 74th St Ste 211",
            "city": "Kenosha",
            "state": "WI",
            "country_code": "US",
            "postal_code": "531426810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Noble Journey LLC
• Gerald Joseph Nora, M.D.
• Nova Dental LLC
• Jerome Novak, PT
• Ned R. Novsam, M.D.
• Beth Nowikowski, PTA
• NSH Kenosha LLC
• Matthew A Nuciforo, PT, DPT, OCS
• Anne Nudi, DNP, APRN, FNP-BC
• Michael J Nute, DPM

• All providers in Kenosha, WI
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.