Individual provider Active NPI

Lisa Farris, OTR

  • Occupational Therapist
  • Grand Rapids, MI
National Provider Identifier
1154824670
Registry record updated Mar 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5201001881 Issued in MI
Practice address
1401 Cedar St NE
Grand Rapids, MI 49503-1375
Phone
(616) 486-3900
NPI assigned
Mar 11, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5201001881 MI Primary

Addresses

Primary practice location

1401 Cedar St NE
Grand Rapids, MI 49503-1375

Mailing address

5700 Dix Dr NE
Belmont, MI 49306-9060

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
5201001881MIMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1520726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520726400000",
    "number": "1154824670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 DIX DR NE",
            "city": "BELMONT",
            "state": "MI",
            "postal_code": "493069060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 CEDAR ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031375",
            "telephone_number": "616-486-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRIS",
        "first_name": "LISA",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-11",
        "last_updated": "2018-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201001881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2018; 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.