Individual provider Active NPI

Lindsey Ryan Dibble, OT R/L

  • Occupational Therapist
  • Corfu, NY
National Provider Identifier
1609128685
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
017644-1 Issued in NY
Practice address
7920 Short St
Corfu, NY 14036-9727
Phone
(585) 762-6442
NPI assigned
Oct 15, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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 017644-1 NY Primary

Addresses

Primary practice location

7920 Short St
Corfu, NY 14036-9727

Mailing address

7920 Short St
Corfu, NY 14036-9727
Phone (585) 762-6442

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
017644-1NYMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1609128685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 SHORT ST",
            "city": "CORFU",
            "state": "NY",
            "postal_code": "140369727",
            "telephone_number": "585-762-6442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 SHORT ST",
            "city": "CORFU",
            "state": "NY",
            "postal_code": "140369727",
            "telephone_number": "585-762-6442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBBLE",
        "first_name": "LINDSEY",
        "middle_name": "RYAN",
        "name_prefix": "Ms.",
        "credential": "OT R/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "017644-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corfu, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.

Verify at the official NPI Registry.