Individual provider Active NPI

Lori Marie Pippen, OTR

  • Pediatric Occupational Therapist
  • Texarkana, TX
National Provider Identifier
1720160070
Registry record updated Jul 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
109611 Issued in TX
Practice address
1710 Moores LN
Texarkana, TX 75503-1858
Phone
(903) 794-2705
Fax
(903) 793-0058
NPI assigned
Oct 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OTR1547 AR
Pediatric Occupational Therapist 225XP0200X 109611 TX Primary

Addresses

Primary practice location

1710 Moores LN
Texarkana, TX 75503-1858

Mailing address

PO Box 186
Maud, TX 75567-0186
Phone (903) 585-3322

Other identifiers 1

IdentifierTypeStateIssuer
021289601MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Lpippen@tmrctxk.org Direct

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
109611TXMDClinical Social Worker
OTR1547ARMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Temple Memorial Pediatric Center Inc. CurrentSince Jul 12, 2020 Accepting new patients

Locations

1710 Moores Ln
Texarkana, TX 75503
Phone (903) 794-2705

Interoperability endpoints

  • Direct secure messaging: lpippen@tmrctxk.org

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593993600000",
    "number": "1720160070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 186",
            "city": "MAUD",
            "state": "TX",
            "postal_code": "755670186",
            "telephone_number": "903-585-3322",
            "fax_number": "903-585-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 MOORES LN",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755031858",
            "telephone_number": "903-794-2705",
            "fax_number": "903-793-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIPPEN",
        "first_name": "LORI",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "AR",
            "license": "OTR1547",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "TX",
            "license": "109611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021289601",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Lpippen@tmrctxk.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1710 Moores Ln",
            "city": "Texarkana",
            "state": "TX",
            "country_code": "US",
            "postal_code": "755031858",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Texarkana, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.