Lisa Jean Jeffrey Brown, OTR/L

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

100408 Issued in MN

Practice address

1505 Central Ave NW
East Grand Forks, MN 56721-1301

Phone

(701) 739-6403

NPI assigned

Jun 20, 2019

Last updated

Mar 2, 2022By the provider in NPPES

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

• Lisa J Brown Other name

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Area Special Education Cooperative #997

  • Local Education Agency (LEA)
  • East Grand Forks, MN
  • NPI 1487741963
  NPD (past)

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

{
    "created_epoch": "1560988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1205496346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 9TH ST SE",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567213008",
            "telephone_number": "701-739-6403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 CENTRAL AVE NW",
            "city": "EAST GRAND FORKS",
            "state": "MN",
            "postal_code": "567211301",
            "telephone_number": "701-739-6403"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 9th St W",
            "address_purpose": "LOCATION",
            "city": "Ada",
            "state": "MN",
            "postal_code": "565101279",
            "country_code": "US",
            "telephone_number": "218-784-5253",
            "fax_number": "218-784-5229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 Crescent Dr",
            "address_purpose": "LOCATION",
            "city": "Thompson",
            "state": "ND",
            "postal_code": "582784320",
            "country_code": "US",
            "telephone_number": "218-793-2582",
            "fax_number": "701-213-4106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEFFREY BROWN",
        "first_name": "LISA",
        "middle_name": "JEAN",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-20",
        "last_updated": "2022-03-02",
        "certification_date": "2022-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "100408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "BROWN",
            "middle_name": "J",
            "credential": "OTR/L",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pediatric Occupational Therapist in East Grand Forks, MN
• Providers in East Grand Forks, MN by specialty
• Pediatric Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.