Active NPI
Lisa Young, M.S., OT
- Occupational Therapist
- Milwaukee, WI
National Provider Identifier
1043580152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5126-26
- Practice address
- 3090 N 53Rd St
Milwaukee, WI 53210-1617 - Phone
- (414) 449-4444
- Fax
- (414) 449-4448
- NPI assigned
- Jan 5, 2012
- Sex
- Female
- Sole proprietor
- No
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 | 5126-26 | WI | Primary |
Addresses
Primary practice location
3090 N 53Rd St
Milwaukee, WI 53210-1617
Mailing address
1016 Milwaukee Ave
South Milwaukee, WI 53172-2006
Phone (414) 571-5566
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5126-26 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Easter Seals Southeast Wisconsin | Occupational Therapist | Past | Accepting new patients |
| Easter Seals Southeast Wisconsin | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Case Management Agency
- West Allis, WI
- NPI 1053397869
Occupational Therapist
-
- Respite Care
- South Milwaukee, WI
- NPI 1073839528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1325721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1325721600000",
"number": "1043580152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1016 MILWAUKEE AVE",
"city": "SOUTH MILWAUKEE",
"state": "WI",
"postal_code": "531722006",
"telephone_number": "414-571-5566",
"fax_number": "414-571-5568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3090 N 53RD ST",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532101617",
"telephone_number": "414-449-4444",
"fax_number": "414-449-4448"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YOUNG",
"first_name": "LISA",
"credential": "M.S., OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-05",
"last_updated": "2012-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "5126-26",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.