Lori Pendergrass, MS OTR/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

2013020044 Issued in MO

Practice address

910 Springfield Rd
Willow Springs, MO 65793

Phone

(417) 217-1811

NPI assigned

Jan 2, 2014

Last updated

Aug 7, 2020By the provider in NPPES

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 names 1

• Lori Gaspard Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Small Town Physical Therapy, LLC

  • Physical Therapist
  • Willow Springs, MO
  • NPI 1366023913
  NPD
• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596758400000",
    "number": "1023439403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 392",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "657930392",
            "telephone_number": "417-217-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 SPRINGFIELD RD",
            "city": "WILLOW SPRINGS",
            "state": "MO",
            "postal_code": "65793",
            "telephone_number": "417-217-1811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Kentucky Ave",
            "address_purpose": "LOCATION",
            "city": "West Plains",
            "state": "MO",
            "postal_code": "65775",
            "country_code": "US",
            "telephone_number": "417-257-5959",
            "fax_number": "417-257-5814",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENDERGRASS",
        "first_name": "LORI",
        "name_prefix": "Mrs.",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-02",
        "last_updated": "2020-08-07",
        "certification_date": "2020-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MO",
            "license": "2013020044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "GASPARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ozarks Medical Center (Ozarks Medical Center Willow Springs)
• Ozarks Medical Center (Ozarks Medical Center Willow Springs)
• Ozarks Medical Center (Willow Springs Ambulance)
• Ozarks Medical Center (Ozarks Healthcare)
• Dawn Marie Paterson, LMT/PTA
• Katie Marie Phipps
• Alexander Mark Prorok, LPC
• Breanna Kay Rader, RBT
• Regional Services (Medical Clinic of Willow Springs)
• Restore the Joy LLC

• Occupational Therapy Assistant in Willow Springs, MO
• Providers in Willow Springs, MO by specialty
• Occupational Therapy Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2020; 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.