Lisa Ann Gross, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

1218.67 Issued in WI

Practice address

N7135 Rocky Knoll Pkwy
Plymouth, WI 53073-3103

Phone

(920) 893-6441

NPI assigned

Dec 19, 2011

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

Other identifiers 1

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": "1324252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324252800000",
    "number": "1467721597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W6570 HWY MM",
            "city": "ELKHART LAKE",
            "state": "WI",
            "postal_code": "530201508",
            "telephone_number": "920-980-9591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N7135 ROCKY KNOLL PKWY",
            "city": "PLYMOUTH",
            "state": "WI",
            "postal_code": "530733103",
            "telephone_number": "920-893-6441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-19",
        "last_updated": "2011-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "1218.67",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED OCC THERAPIST ASSISTANT",
            "identifier": "1218.27",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Giebel, CWP
• Jose Joaquin Giraud, DMD
• Corrie Goodine, DPT
• Bethany L Graesslin, PT
• Thomas Gregory Graf
• Michelle R. Haese, CAPSW, CSAC
• Derek J Harmelink, PA
• Bonnie Harney, RN
• Emily Joy Hauck, D.C.
• Healthy Living Acupuncture

• Occupational Therapy Assistant in Plymouth, WI
• Providers in Plymouth, WI by specialty
• Occupational Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2011; 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.