Active NPI
Lisa Villafuerte Watt, OTR
- Occupational Therapist
- Grand Island, NY
National Provider Identifier
1467703488
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 04707
- Practice address
- 263 Forest Creek LN
Grand Island, NY 14072-3507 - Phone
- (716) 775-9288
- NPI assigned
- Oct 1, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 04707 | NY | Primary |
Addresses
Primary practice location
263 Forest Creek LN
Grand Island, NY 14072-3507
Mailing address
263 Forest Creek LN
Grand Island, NY 14072-3507
Phone (716) 775-9288
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
| License | State | Type | Specialty |
|---|---|---|---|
| 04707 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349049600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349049600000",
"number": "1467703488",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 FOREST CREEK LN",
"city": "GRAND ISLAND",
"state": "NY",
"postal_code": "140723507",
"telephone_number": "716-775-9288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 FOREST CREEK LN",
"city": "GRAND ISLAND",
"state": "NY",
"postal_code": "140723507",
"telephone_number": "716-775-9288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATT",
"first_name": "LISA",
"middle_name": "VILLAFUERTE",
"name_prefix": "Mrs.",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-01",
"last_updated": "2012-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "04707",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.