Active NPI
Martha Sloan Lake, OT
- Occupational Therapist
- Pulaski, TN
National Provider Identifier
1689701948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 203 Village SQ
Pulaski, TN 38478-2929 - Phone
- (931) 424-5588
- Fax
- (931) 424-5590
- NPI assigned
- Feb 27, 2007
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
203 Village SQ
Pulaski, TN 38478-2929
Mailing address
215 N Crescent View Rd
Pulaski, TN 38478-8770
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4069718 | Other | TN | BLUE CROSS PROVIDER # |
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": "1172534400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689701948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "215 N CRESCENT VIEW RD",
"city": "PULASKI",
"state": "TN",
"postal_code": "384788770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 VILLAGE SQ",
"city": "PULASKI",
"state": "TN",
"postal_code": "384782929",
"telephone_number": "931-424-5588",
"fax_number": "931-424-5590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "MARTHA",
"middle_name": "SLOAN",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER #",
"identifier": "4069718",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pulaski, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.