Individual provider Active NPI

Luz Adriana Wolf, OTR/L

  • Pediatric Occupational Therapist
  • Germantown, TN
National Provider Identifier
1215364567
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
2309 Issued in TN
Practice address
2100 Exeter Rd Ste 210
Germantown, TN 38138-3966
Phone
(901) 701-5604
NPI assigned
Oct 2, 2013
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 2309 TN Primary

Addresses

Primary practice location

2100 Exeter Rd Ste 210
Germantown, TN 38138-3966

Mailing address

965 Ridge Lake Blvd
Memphis, TN 38120-9401

Other practice location 1

2100 Exeter Rd
Germantown, TN 38138-3966
Phone (901) 757-1350

Other practice location 2

7424 US Highway 64 Ste 112
Bartlett, TN 38133-8937
Phone (901) 385-3877

Other practice location 3

2120 Exeter Rd Ste 140
Germantown, TN 38138-3964
Phone (901) 757-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170825003031 TN Practitioner - Occupational Therapist in Private Practice 8820360829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1380672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1215364567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "965 RIDGE LAKE BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 EXETER RD STE 210",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381383966",
            "telephone_number": "901-701-5604"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Exeter Rd",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383966",
            "country_code": "US",
            "telephone_number": "901-757-1350",
            "fax_number": "901-757-3496",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7424 US Highway 64 Ste 112",
            "address_purpose": "LOCATION",
            "city": "Bartlett",
            "state": "TN",
            "postal_code": "381338937",
            "country_code": "US",
            "telephone_number": "901-385-3877",
            "fax_number": "901-385-3874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2120 Exeter Rd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Germantown",
            "state": "TN",
            "postal_code": "381383964",
            "country_code": "US",
            "telephone_number": "901-757-1350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "LUZ",
        "middle_name": "ADRIANA",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-02",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TN",
            "license": "2309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.