Active NPI
Lisa Ann Vanetten, OTR
- Occupational Therapist
- Advance, NC
National Provider Identifier
1295931632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5554
- Practice address
- 142 Bermuda Village Dr
Advance, NC 27006-7867 - Phone
- (336) 940-6433
- NPI assigned
- Jun 22, 2007
- 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 | 5554 | NC | Primary |
Addresses
Primary practice location
142 Bermuda Village Dr
Advance, NC 27006-7867
Mailing address
5120 Carversham CT
Winston Salem, NC 27106-4783
Phone (336) 765-1849
Other names 1
- Mrs. Lisa Ann Hrabovsky
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 |
|---|---|---|---|
| 5554 | NC | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295931632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5120 CARVERSHAM CT",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271064783",
"telephone_number": "336-765-1849"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 BERMUDA VILLAGE DR",
"city": "ADVANCE",
"state": "NC",
"postal_code": "270067867",
"telephone_number": "336-940-6433"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANETTEN",
"first_name": "LISA",
"middle_name": "ANN",
"name_prefix": "Miss",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "5554",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "HRABOVSKY",
"middle_name": "ANN",
"prefix": "MRS.",
"credential": "OTR",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Advance, NC
- The Cardinal Assisted Living LLC
- Thomas S. Browder DDS
- Lindsay Elizabeth Thornton, OD
- Franklin Lee Tolbert, MD
- Maria Ann Trowbridge, OTR/L
- Ryan Carpenter Vann, PA-C
- Frankie Vaughn
- Wake Forest University Baptist Medical Center Community Physicians (Hillsdale Family Practice)
- Wake Forest University Health Sciences (Ashley Furniture Wellness Center)
- Wake Forest University Health Sciences (Orthopaedic & Sports Medicine - RISE)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.