Active NPI
Shaena Lutz, COTA/L
- Specialist
- Chandler, AZ
National Provider Identifier
1699150318
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 6216
- Practice address
- 1889 W Queen Creek Rd
#2062
Chandler, AZ 85248-3079 - Phone
- (602) 410-3062
- NPI assigned
- Jul 23, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 6216 | AZ | Primary |
Addresses
Primary practice location
1889 W Queen Creek Rd
#2062
Chandler, AZ 85248-3079
Mailing address
1889 West Queen Creek Road
#2062
Chandler, AZ 85248
Phone (602) 410-3062
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6216 | Other | AZ | OCCUPATIONAL THERAPY ASSISTANT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6216 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437609600000",
"number": "1699150318",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1889 WEST QUEEN CREEK ROAD",
"address_2": "#2062",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "85248",
"telephone_number": "602-410-3062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1889 W QUEEN CREEK RD",
"address_2": "#2062",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852483079",
"telephone_number": "602-410-3062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUTZ",
"first_name": "SHAENA",
"credential": "COTA/L",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-23",
"last_updated": "2015-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "AZ",
"license": "6216",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OCCUPATIONAL THERAPY ASSISTANT",
"identifier": "6216",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.