Lisa Marie Lutes I, OTR

Primary specialty

Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X

License

5201002140 Issued in MI

Practice address

41155 Pond View Dr
Sterling Heights, MI 48314-3891

Phone

(586) 739-9494

NPI assigned

Jun 19, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1497830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497830400000",
    "number": "1285164558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21104 FRAZHO ST",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480813125",
            "telephone_number": "586-489-1211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41155 POND VIEW DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483143891",
            "telephone_number": "586-739-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUTES",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "name_suffix": "I",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-19",
        "last_updated": "2017-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0019X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "MI",
            "license": "5201002140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Rehabilitation Occupational Therapist in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Physical Rehabilitation Occupational Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; 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.