Lisa G. Wren, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR1502 Issued in AR

Practice address

12018 Highway 196
Texarkana, AR 71854-1280

Phone

(870) 653-4343

NPI assigned

Dec 14, 2005

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Haynes Sports Therapy and Rehab, Inc.

  • Physical Therapy Clinic/Center
  • Hope, AR
  • NPI 1902894660
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1033194980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 HIGHWAY 332",
            "city": "PRESCOTT",
            "state": "AR",
            "postal_code": "718579320",
            "telephone_number": "870-777-6798",
            "fax_number": "870-887-6880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12018 HIGHWAY 196",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718541280",
            "telephone_number": "870-653-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WREN",
        "first_name": "LISA",
        "middle_name": "G.",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR1502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141437721",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "OTR1502",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laketa Shavonne Woods, LVN
• Cally Wooley
• Cathy Alison Word, PHD
• Daisey Worley, MHPP
• WPM Community Pharmacies, LLC (Allcare Pharmacy)
• Mark A Wren, M.D.
• John W Wright, MHPP
• Natalia Wright, MHPP
• Amber Wyman
• Earnest Wyrick, MHPP

• Occupational Therapist in Texarkana, AR
• Providers in Texarkana, AR by specialty
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.