Lisa Ann Wommack, OCCUPATIONAL THERAPI

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT002037 Issued in GA

Practice address

1199 Prince Ave
Athens, GA 30606-2797

Phone

(706) 475-5820

NPI assigned

May 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831309350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CHADDS WALK",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306061472",
            "telephone_number": "706-546-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1199 PRINCE AVE",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062797",
            "telephone_number": "706-475-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMMACK",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "OCCUPATIONAL THERAPI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT002037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Montana Carter Wollenhaupt, PA
• Women's Comp Healthcare Ctr. P.C.
• Women's Healthcare Associates of Athens, LLC
• Women's Healthcare Associates, P.C
• Women's Healthcare Specialist of Athens LLC
• Erin Gaines Wood, NURSE PRACTITIONER
• Jaimee Wood
• Jennifer Clements Wood, LPC
• Jimmy Haralson Wood Jr., PT
• Michael Neil Woodall, MD

• Occupational Therapist in Athens, GA
• Providers in Athens, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.