NPIMap

Individual provider Active NPI

Lana Kareen Broome, OTR

  • Occupational Therapist
  • Clarksville, TN
National Provider Identifier
1487706701
Registry record updated Apr 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2156 Issued in TN
Practice address
298 Warfield Blvd Apt C
Clarksville, TN 37043-1896
Phone
(931) 906-0440
Fax
(931) 920-5070
NPI assigned
Jan 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2156 TN Primary

Addresses

Primary practice location

298 Warfield Blvd Apt C
Clarksville, TN 37043-1896

Mailing address

298 Warfield Blvd Apt C
Clarksville, TN 37043-1896
Phone (931) 906-0440

Other identifiers 2

IdentifierTypeStateIssuer
4004828OtherTNBCBS GROUP ID NUMBER
4004828OtherTNTENNCARE ID NUMBER

Other names 1

  • Lana Kareen Barnes Former name

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
2156TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Full Spectrum Pediatric Therapy Current Accepting new patients
Full Spectrum Pediatric Therapy, Inc. Occupational Therapist Current Accepting new patients

Locations

298 Warfield Blvd
Apt C
Clarksville, TN 37043
Phone (931) 906-0440

1842 Wilma Rudolph Blvd
Clarksville, TN 37040
Phone (931) 906-0440

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1487706701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 WARFIELD BLVD APT C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431896",
            "telephone_number": "931-906-0440",
            "fax_number": "931-920-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 WARFIELD BLVD APT C",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431896",
            "telephone_number": "931-906-0440",
            "fax_number": "931-920-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOME",
        "first_name": "LANA",
        "middle_name": "KAREEN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "2156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP ID NUMBER",
            "identifier": "4004828",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNCARE ID NUMBER",
            "identifier": "4004828",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LANA",
            "last_name": "BARNES",
            "middle_name": "KAREEN",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2022; 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.