Active NPI
Robert Max Lish, OTR/L
- Occupational Therapist
- Elko, NV
National Provider Identifier
1285313221
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OT-2876
- Practice address
- 3565 Autumn Colors Dr
Elko, NV 89801-7800 - Phone
- (208) 241-3844
- NPI assigned
- Jul 17, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 | OT-2876 | NV | Primary |
Addresses
Primary practice location
3565 Autumn Colors Dr
Elko, NV 89801-7800
Mailing address
3565 Autumn Colors Dr
Elko, NV 89801-7800
Phone (208) 241-3844
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 |
|---|---|---|---|
| OT-2876 | NV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1285313221",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3565 AUTUMN COLORS DR",
"city": "ELKO",
"state": "NV",
"postal_code": "898017800",
"telephone_number": "208-241-3844"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3565 AUTUMN COLORS DR",
"city": "ELKO",
"state": "NV",
"postal_code": "898017800",
"telephone_number": "208-241-3844"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LISH",
"first_name": "ROBERT",
"middle_name": "MAX",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-17",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": "NV",
"license": "OT-2876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elko, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.