Lisa Gay Wade, OTRL

Primary specialty

SpecialistTaxonomy code 174400000X

License

0106 Issued in AL

Practice address

557 Glover Ave Ste 5
Enterprise, AL 36330-2070

Phone

(334) 347-0234

Fax

(334) 393-4495

NPI assigned

Dec 5, 2006

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

• Mrs. Lisa Gay Skeen Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154489516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "557 GLOVER AVE STE 5",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302070",
            "telephone_number": "334-347-0234",
            "fax_number": "334-393-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "557 GLOVER AVE STE 5",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302070",
            "telephone_number": "334-347-0234",
            "fax_number": "334-393-4495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADE",
        "first_name": "LISA",
        "middle_name": "GAY",
        "name_prefix": "Mrs.",
        "credential": "OTRL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "0106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SKEEN",
            "middle_name": "GAY",
            "prefix": "MRS.",
            "credential": "OTRL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Specialist in Enterprise, AL
• Providers in Enterprise, AL by specialty
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.