Lisa B Wild, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3619 Issued in AZ

Practice address

9494 E Becker Lane
Life Care Center of Scottsdale
Scottsdale, AZ 85260

Phone

(480) 760-4236

NPI assigned

Jun 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Ms. Lisa B Glen Former 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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266969600000",
    "number": "1235332214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9494 E BECKER LANE",
            "address_2": "LIFE CARE CENTER OF SCOTTSDALE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85260",
            "telephone_number": "480-760-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9494 E BECKER LANE",
            "address_2": "LIFE CARE CENTER OF SCOTTSDALE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85260",
            "telephone_number": "480-760-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "LISA",
        "middle_name": "B",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2010-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "3619",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006730",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "3633",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "GLEN",
            "middle_name": "B",
            "prefix": "MS.",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Katherine Jade Wiland, MSC
• Susan Wilansky Markowitz, M.D.
• Ashley Josephine Wilcox, CPM
• Justin Graham Wilcox, PA-C
• Robert Daniel Wilcoxson, M.D.
• Daniella C Wilde, FNP-C
• Heather Aura Wilde, NMD
• Kailey Wilde
• Evan Wilder, MD
• Susan S Wilder, M.D

• Occupational Therapist in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2010; 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.