Active NPI
Lisa Gerard Faulise, MS
- Pediatric Occupational Therapist
- Rumford, RI
National Provider Identifier
1609910280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Occupational Therapist
- License
- MO2005013549
- Practice address
- 20 Newman Ave.
Suite 1025
Rumford, RI 02916 - Phone
- (401) 610-0639
- NPI assigned
- Feb 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 000116 | RI | |
| Pediatric Occupational Therapist | 225XP0200X | MO2005013549 | MO | Primary |
Addresses
Primary practice location
20 Newman Ave.
Suite 1025
Rumford, RI 02916
Mailing address
15 Loop Drive
North Kingston, RI 02852
Phone (401) 610-0639
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MO2005013549 | MO | MD | Pediatric Occupational Therapist |
| 000116 | RI | MD | Pediatric Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723161600000",
"number": "1609910280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 LOOP DRIVE",
"city": "NORTH KINGSTON",
"state": "RI",
"postal_code": "02852",
"telephone_number": "401-610-0639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 NEWMAN AVE.",
"address_2": "SUITE 1025",
"city": "RUMFORD",
"state": "RI",
"postal_code": "02916",
"telephone_number": "401-610-0639"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAULISE",
"first_name": "LISA",
"middle_name": "GERARD",
"name_prefix": "Mrs.",
"credential": "MS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2024-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "RI",
"license": "000116",
"primary": false
},
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "MO",
"license": "MO2005013549",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rumford, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.