Corley Brooks Lyle, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

5411 Issued in SC

Practice address

605 Johnston Rd
Ninety Six, SC 29666-1417

Phone

(864) 543-3100

NPI assigned

Aug 16, 2022

Last updated

Aug 16, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greenwood School District 52

  • Student in an Organized Health Care Education/Training Program
  • Ninety Six, SC
  • NPI 1588684823
  NPD (past)

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

{
    "created_epoch": "1660608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1629796677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 DEVORE RD",
            "city": "GREENWOOD",
            "state": "SC",
            "postal_code": "296499555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 JOHNSTON RD",
            "city": "NINETY SIX",
            "state": "SC",
            "postal_code": "296661417",
            "telephone_number": "864-543-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYLE",
        "first_name": "CORLEY",
        "middle_name": "BROOKS",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-16",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "5411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerianne Hammond
• Susan J Hardesty, MD
• Home Care Medical AIDS Inc of Ninety Six
• Stephanie P Lewis, APRN
• Jennifer Smith Lindler, LPC
• Lisa Wise Miller, RN
• Taylor Miller
• Melissa Dawn Morrison
• Swetha Narala, MD
• Ninety Six Pharmacy, Inc. (Family Pharmacy)

• Occupational Therapy Assistant in Ninety Six, SC
• Providers in Ninety Six, SC by specialty
• Occupational Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.