Individual provider Active NPI

Lorissa Depalma

  • Occupational Therapy Assistant
  • Sun City West, AZ
National Provider Identifier
1104257708
Registry record updated Dec 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
4972 Issued in AZ
Practice address
14505 W Granite Valley Dr
Sun City West, AZ 85375-5795
Phone
(623) 975-8100
NPI assigned
Dec 6, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 4972 AZ Primary

Addresses

Primary practice location

14505 W Granite Valley Dr
Sun City West, AZ 85375-5795

Mailing address

14505 W Granite Valley Dr
Sun City West, AZ 85375-5795

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

State licenses

LicenseStateTypeSpecialty
4972AZMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1386288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386288000000",
    "number": "1104257708",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14505 W GRANITE VALLEY DR",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14505 W GRANITE VALLEY DR",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755795",
            "telephone_number": "623-975-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPALMA",
        "first_name": "LORISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-06",
        "last_updated": "2013-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AZ",
            "license": "4972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2013; 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.