Active NPI
Lauren Lichty
- Pediatric Physical Therapist
- West Fork, AZ
National Provider Identifier
1609488014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- Practice address
- 363 McKnight Ave
West Fork, AZ 72774 - Phone
- (479) 839-3035
- NPI assigned
- Aug 18, 2020
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | Primary |
Addresses
Primary practice location
363 McKnight Ave
West Fork, AZ 72774
Mailing address
PO Box 419
West Fork, AR 72774-0419
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597708800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597708800000",
"number": "1609488014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 419",
"city": "WEST FORK",
"state": "AR",
"postal_code": "727740419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "363 MCKNIGHT AVE",
"city": "WEST FORK",
"state": "AZ",
"postal_code": "72774",
"telephone_number": "479-839-3035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LICHTY",
"first_name": "LAUREN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-18",
"last_updated": "2020-08-18",
"certification_date": "2020-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.