Active NPI
Lori Lynn Russo, OT
- Occupational Therapist
- Menomonee Falls, WI
National Provider Identifier
1558547489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 3208-026
- Practice address
- W143N5009 Brook Falls Dr
Menomonee Falls, WI 53051-6987 - Phone
- (262) 781-8352
- NPI assigned
- Jan 9, 2008
- 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 | 3208-026 | WI | Primary |
Addresses
Primary practice location
W143N5009 Brook Falls Dr
Menomonee Falls, WI 53051-6987
Mailing address
1680 Berkshire Dr
Elm Grove, WI 53122-1502
Phone (414) 529-9982
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3208-026 | WI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199836800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199836800000",
"number": "1558547489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1680 BERKSHIRE DR",
"city": "ELM GROVE",
"state": "WI",
"postal_code": "531221502",
"telephone_number": "414-529-9982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W143N5009 BROOK FALLS DR",
"city": "MENOMONEE FALLS",
"state": "WI",
"postal_code": "530516987",
"telephone_number": "262-781-8352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSO",
"first_name": "LORI",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-09",
"last_updated": "2008-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "3208-026",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menomonee Falls, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.