Individual provider Active NPI

Lillian F Damico, OTR/L

  • Occupational Therapist
  • Dallas, TX
National Provider Identifier
1629587712
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT010001371 Issued in DC
Practice address
8840 Cypress Waters Blvd, Suite 300
Dallas, TX 75019
Phone
(469) 524-5512
NPI assigned
Sep 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0119006847 VA
Occupational Therapist 225X00000X OT010001371 DC Primary

Addresses

Primary practice location

8840 Cypress Waters Blvd, Suite 300
Dallas, TX 75019

Mailing address

87 Rolling Green Dr
Staunton, VA 24401-9700
Phone (540) 290-9158

Other practice location 1

1200 1st St NE
Washington, DC 20002-3361
Phone (540) 290-9158

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
OT010001371DCMDOccupational Therapist
0119006847VAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629587712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 ROLLING GREEN DR",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244019700",
            "telephone_number": "540-290-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 CYPRESS WATERS BLVD, SUITE 300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75019",
            "telephone_number": "469-524-5512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 1st St NE",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200023361",
            "country_code": "US",
            "telephone_number": "540-290-9158",
            "fax_number": "540-290-9158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMICO",
        "first_name": "LILLIAN",
        "middle_name": "F",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119006847",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "DC",
            "license": "OT010001371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.