Lacey Sanborn Dunlap, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT2267 Issued in MS

Practice address

83 Airways PL
Southaven, MS 38671-5885

Phone

(662) 349-8787

NPI assigned

Apr 13, 2012

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

Enrolled in MS

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Tri-Vista Rehab, Inc

  • Physical Therapist
  • Tupelo, MS
  • NPI 1982799516

  Occupational Therapist

  Medicare reassignment NPD
• Tri-Vista Rehab, Inc

  • Rehabilitation Clinic/Center
  • Richton, MS
  • NPI 1265025522
  NPD

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1437416534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3460 PENDULUM DR E",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386328395",
            "telephone_number": "662-803-6328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 AIRWAYS PL",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386715885",
            "telephone_number": "662-349-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNLAP",
        "first_name": "LACEY",
        "middle_name": "SANBORN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-13",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "OT2267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Michael Dudley, RD
• Mary Michelle Dukes, PTA
• Madison Dulin
• Kristen Lee Duncan, WHNP-BC
• Ulric Dave Duncan, M.D.
• Stevie Lamar Dunn, RN
• Molly Luhrs Dunson, RN, FNP-C
• Vinh Duong, M.D.
• Stephanie J Durden, ARNP
• Jaimie Lee Dutoit, LPC-MHSP, LPC-S

• Occupational Therapist in Southaven, MS
• Providers in Southaven, MS by specialty
• Occupational Therapist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.

Verify at the official NPI Registry.