Lori Marie Ingram, COTAL

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

0A1383 Issued in ME

Practice address

587 North Deer Isle Rd
Island Nursing Home
Deer Isle, ME 04627

Phone

(207) 348-2351

Fax

(207) 348-6154

NPI assigned

Jun 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Lori Marie Dezarn Former name

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": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326241530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5",
            "address_2": "396 SUNSET RD",
            "city": "SUNSET",
            "state": "ME",
            "postal_code": "046830005",
            "telephone_number": "207-348-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "587 NORTH DEER ISLE RD",
            "address_2": "ISLAND NURSING HOME",
            "city": "DEER ISLE",
            "state": "ME",
            "postal_code": "04627",
            "telephone_number": "207-348-2351",
            "fax_number": "207-348-6154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INGRAM",
        "first_name": "LORI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "COTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "ME",
            "license": "0A1383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "DEZARN",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "COTAL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ruth Helen Eaton
• Kamryn Foss
• Colleen Comer Hansen, BSN RN
• Joseph Adam Hermans
• Erin Hutchins, MSPT
• Island Nursing Home, Inc
• Caitlin Johnston, PTA
• Laurie Lynn Marcel, COTA/L
• Memorial Ambulance Corps. Isle Au Haut - Stonington - Deer Isle (Memorial Ambulance Corps.)
• Hollan S Oliver, DPT

• Occupational Therapy Assistant in Deer Isle, ME
• Providers in Deer Isle, ME by specialty
• Occupational Therapy Assistant in Maine

• 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.

Verify at the official NPI Registry.