Lisa Ferguson Minerich, OTR/L

Primary specialty

Gerontology Occupational TherapistTaxonomy code 225XG0600X

License

7631 Issued in NC

Practice address

4800 S Croatan Hwy
Nags Head, NC 27959-9704

Phone

(252) 449-4560

NPI assigned

Nov 8, 2020

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1604793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604793600000",
    "number": "1316548001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FERN LN",
            "city": "SOUTHERN SHORES",
            "state": "NC",
            "postal_code": "279493719",
            "telephone_number": "301-785-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 S CROATAN HWY",
            "city": "NAGS HEAD",
            "state": "NC",
            "postal_code": "279599704",
            "telephone_number": "252-449-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINERICH",
        "first_name": "LISA",
        "middle_name": "FERGUSON",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-08",
        "last_updated": "2020-11-08",
        "certification_date": "2020-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapist, Gerontology",
            "state": "NC",
            "license": "7631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gerontology Occupational Therapist in Nags Head, NC
• Providers in Nags Head, NC by specialty
• Gerontology Occupational Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2020; 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.