Individual provider Active NPI

Lisa E Towery, OTR-L

  • Pediatric Occupational Therapist
  • Jacksonville, FL
National Provider Identifier
1336350602
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT 14693 Issued in FL
Practice address
6373 Autumn Berry Cir
Jacksonville, FL 32258-8416
Phone
(049) 079-4629
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT14693 FL
Pediatric Occupational Therapist 225XP0200X OT 14693 FL Primary

Addresses

Primary practice location

6373 Autumn Berry Cir
Jacksonville, FL 32258-8416

Mailing address

6373 Autumn Berry Cir
Jacksonville, FL 32258-8416
Phone (904) 907-9462

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

LicenseStateTypeSpecialty
OT14693FLMDOccupational Therapist
OT 14693FLMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1336350602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6373 AUTUMN BERRY CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322588416",
            "telephone_number": "904-907-9462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6373 AUTUMN BERRY CIR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322588416",
            "telephone_number": "049-079-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOWERY",
        "first_name": "LISA",
        "middle_name": "E",
        "credential": "OTR-L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT14693",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT 14693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2025; 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.