Active NPI
Lori S. McWilliams Gersbach, MOT, OTR/L, CHT
- Hand Occupational Therapist
- Midland, TX
National Provider Identifier
1427164110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hand Occupational Therapist
- License
- 107357
- Practice address
- 3416 W Wall St
Suite 105
Midland, TX 79701-6710 - Phone
- (432) 789-1055
- Fax
- (432) 689-0907
- NPI assigned
- Aug 22, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hand Occupational Therapist | 225XH1200X | 107357 | TX | Primary |
Addresses
Primary practice location
3416 W Wall St
Suite 105
Midland, TX 79701-6710
Mailing address
PO Box 10641
Midland, TX 79702-7641
Phone (432) 935-3479
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107357 | Other | TX | STATE LICENSE NUMBER |
| 1011842 | Other | NAT'L CERTIFICATION # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070720000695 | TX | Practitioner - Occupational Therapist in Private Practice | 0345341384 | Practice locations: Midland, TX |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107357 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186704000000",
"number": "1427164110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10641",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797027641",
"telephone_number": "432-935-3479"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3416 W WALL ST",
"address_2": "SUITE 105",
"city": "MIDLAND",
"state": "TX",
"postal_code": "797016710",
"telephone_number": "432-789-1055",
"fax_number": "432-689-0907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCWILLIAMS GERSBACH",
"first_name": "LORI",
"middle_name": "S.",
"credential": "MOT, OTR/L, CHT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2007-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "225XH1200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Hand",
"state": "TX",
"license": "107357",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "107357",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NAT'L CERTIFICATION #",
"identifier": "1011842",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Midland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.