Active NPI
Taylor Lynne Willis, OTR/L
- Occupational Therapist
- Meridian, ID
National Provider Identifier
1245809664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 2400
- Practice address
- 520 S Eagle Rd
Meridian, ID 83642-6351 - Phone
- (509) 899-1461
- NPI assigned
- Jun 21, 2021
- 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 Therapist | 225X00000X | 2400 | ID | Primary |
Addresses
Primary practice location
520 S Eagle Rd
Meridian, ID 83642-6351
Mailing address
520 S Eagle Rd
Meridian, ID 83642-6351
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 |
|---|---|---|---|
| 2400 | ID | MD | Neurology Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624233600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1245809664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 S EAGLE RD",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 S EAGLE RD",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836426351",
"telephone_number": "509-899-1461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "TAYLOR",
"middle_name": "LYNNE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-21",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "ID",
"license": "2400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.