Active NPI
Lisa Jane Eaton, MS OTR/L CAP
- Occupational Therapist
- Powell, WY
National Provider Identifier
1306039888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 686
- Practice address
- 507 N Clark St
Powell, WY 82435-1915 - Phone
- (970) 420-9588
- NPI assigned
- Aug 20, 2007
- Last updated
- Oct 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CAP-190 | WY | |
| Occupational Therapist | 225X00000X | 686 | WY | Primary |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
507 N Clark St
Powell, WY 82435-1915
Mailing address
999 Lane 5
Powell, WY 82435-9740
Phone (970) 420-9588
Other practice location 1
125 S Division St
Powell, WY 82435-2409
Phone (970) 420-9588
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145664400 | Medicaid | WY | |
| 1770688871 | Medicaid | WY |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CAP-190 | WY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635120000000",
"number": "1306039888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "999 LANE 5",
"city": "POWELL",
"state": "WY",
"postal_code": "824359740",
"telephone_number": "970-420-9588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 N CLARK ST",
"city": "POWELL",
"state": "WY",
"postal_code": "824351915",
"telephone_number": "970-420-9588"
}
],
"practiceLocations": [
{
"address_1": "125 S Division St",
"address_purpose": "LOCATION",
"city": "Powell",
"state": "WY",
"postal_code": "824352409",
"country_code": "US",
"telephone_number": "970-420-9588",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EATON",
"first_name": "LISA",
"middle_name": "JANE",
"name_prefix": "Mrs.",
"credential": "MS OTR/L CAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-20",
"last_updated": "2021-10-25",
"certification_date": "2021-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "WY",
"license": "CAP-190",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WY",
"license": "686",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "145664400",
"state": "WY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1770688871",
"state": "WY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Powell, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.