Lisa Douglas, MOT, OTR/L, CLT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT20253 Issued in FL

Practice address

809 Good Homes Rd
Orlando, FL 32818-6628

Phone

(407) 293-3156

Fax

(407) 293-3155

NPI assigned

Feb 25, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Protailored Physical Therapy LLCGroup PAC ID 4385962497, 23 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Protailored Physical Therapy LLC

  • Orthopedic Physical Therapist
  • Fort Wayne, IN
  • NPI 1063805042
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1456358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1760842215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "336 BROAD ST # 203",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613006",
            "telephone_number": "407-293-3156",
            "fax_number": "407-293-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 GOOD HOMES RD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328186628",
            "telephone_number": "407-293-3156",
            "fax_number": "407-293-3155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 29th St",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328056219",
            "country_code": "US",
            "telephone_number": "407-843-3230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2535 Fort Amanda Rd",
            "address_purpose": "LOCATION",
            "city": "Lima",
            "state": "OH",
            "postal_code": "458043728",
            "country_code": "US",
            "telephone_number": "419-999-2055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "LISA",
        "credential": "MOT, OTR/L, CLT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-25",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT.007743",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NM",
            "license": "4031",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT20253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brad H Douglas, MD
• Dorothea N Douglas, M.D.
• Jamia Douglas
• Jocelynn Douglas
• Latoya Jones Douglas, DMD
• Melissa Douglas, APRN
• Tiffany Douglas, RN
• Michelle Douglass
• Bassam M Doujaiji, MD
• Doulas of Orlando, LLC

• Occupational Therapist in Orlando, FL
• Providers in Orlando, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.