Lukas Wavra, MOTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

104542 Issued in MN

Practice address

1020 Lark St
Alexandria, MN 56308-2219

Phone

(320) 759-5062

NPI assigned

Feb 3, 2016

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1454457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1790143980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 LARK ST APT 104",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082332",
            "telephone_number": "218-686-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 LARK ST",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563082219",
            "telephone_number": "320-759-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAVRA",
        "first_name": "LUKAS",
        "name_prefix": "Mr.",
        "credential": "MOTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-03",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "104542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN OCCUPATIONAL THERAPY LICENSE",
            "identifier": "104542",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL BOARD FOR CERTIFICATIOM IN OCCUPATIONAL THERAPY, INC.",
            "identifier": "303564",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda M Walz, M.D.
• John Walz
• Brian Michael Warzecha, CRNA
• Jennessa Marie Nielsen Warzecha, M.D.
• David A Watkin, MD
• Wayne D. Knauf, D.C.P.a.
• Brenna Webster
• Dennis Philip Weigel, MD
• Krystina Weiss, LAMFT
• Well and Company

• Occupational Therapist in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; 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.