Individual provider Active NPI

Lindsey Harris, OTR

  • Physical Rehabilitation Occupational Therapist
  • Petaluma, CA
National Provider Identifier
1619235116
Registry record updated May 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Rehabilitation Occupational TherapistTaxonomy code 225XP0019X
License
112603 Issued in TX
Practice address
101 Monroe St
Petaluma, CA 94954-2328
Phone
(707) 763-4109
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 12428 CA
Physical Rehabilitation Occupational Therapist 225XP0019X 112603 TX Primary
Physical Rehabilitation Occupational Therapist 225XP0019X OT60278533 WA

Addresses

Primary practice location

101 Monroe St
Petaluma, CA 94954-2328

Mailing address

4418 Evelyn St
Amarillo, TX 79109-5336
Phone (806) 674-5298

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
12428CAMDMental Health Counselor
112603TXMDPhysical Rehabilitation Occupational Therapist
OT60278533WAMDPhysical Rehabilitation Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336003200000",
    "number": "1619235116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 EVELYN ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791095336",
            "telephone_number": "806-674-5298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MONROE ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949542328",
            "telephone_number": "707-763-4109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LINDSEY",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2012-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "12428",
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "TX",
            "license": "112603",
            "primary": true
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": "WA",
            "license": "OT60278533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.