Active NPI
Lori Reynolds
- Occupational Therapist
- Broken Arrow, OK
National Provider Identifier
1750996427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 2221 W Detroit St
Broken Arrow, OK 74012-3628 - Phone
- (918) 615-6492
- NPI assigned
- Sep 10, 2020
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
2221 W Detroit St
Broken Arrow, OK 74012-3628
Mailing address
12610 S 73Rd East Ave
Bixby, OK 74008-2646
Phone (870) 314-2885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230620001515 | OK | Practitioner - Occupational Therapist in Private Practice | 7113385469 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5608 | OK | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Collaborative Therapy Services Inc | Past | Accepting new patients | |
| Milestones Pediatric Therapy Services, LLC | Occupational Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Broken Arrow, OK
- NPI 1932344835
-
- Physical Therapist
- Cabot, AR
- NPI 1558734566
Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1599696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1750996427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12610 S 73RD EAST AVE",
"city": "BIXBY",
"state": "OK",
"postal_code": "740082646",
"telephone_number": "870-314-2885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2221 W DETROIT ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740123628",
"telephone_number": "918-615-6492"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "LORI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-10",
"last_updated": "2021-07-30",
"certification_date": "2021-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.