Active NPI
Lisa Walker, COTA
- Occupational Therapy Assistant
- Kenmore, NY
National Provider Identifier
1235917873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 010646
- Practice address
- 2900 Delaware Ave
Kenmore, NY 14217-2309 - Phone
- (871) 988-3716
- NPI assigned
- Sep 15, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 010646 | NY | Primary |
Addresses
Primary practice location
2900 Delaware Ave
Kenmore, NY 14217-2309
Mailing address
5727 Bowmiller Rd
Lockport, NY 14094-9674
Phone (760) 362-9969
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
| License | State | Type | Specialty |
|---|---|---|---|
| 010646 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694736000000",
"number": "1235917873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5727 BOWMILLER RD",
"city": "LOCKPORT",
"state": "NY",
"postal_code": "140949674",
"telephone_number": "760-362-9969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2900 DELAWARE AVE",
"city": "KENMORE",
"state": "NY",
"postal_code": "142172309",
"telephone_number": "871-988-3716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "LISA",
"credential": "COTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-09-15",
"last_updated": "2023-09-15",
"certification_date": "2023-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "NY",
"license": "010646",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenmore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.