Lisa Dolphin, OT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

01090 Issued in IA

Practice address

1717 Boyson Rd
Hiawatha, IA 52233-2313

Phone

(319) 721-9333

NPI assigned

Sep 20, 2019

Sex

Female

Sole proprietor

No

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

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.

• Proactive Pediatric Therapy, LLC

  • Rehabilitation Clinic/Center
  • Hiawatha, IA
  • NPI 1679121933

  Pediatrics

  NPD Authorized official

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

{
    "created_epoch": "1568937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1831749969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 BOYSON RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 BOYSON RD",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332313",
            "telephone_number": "319-721-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLPHIN",
        "first_name": "LISA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-20",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "IA",
            "license": "01090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristin M. Devore, A.R.N.P.
• Janessa Dewees, MA, CCC-SLP
• Jay R Diaz-Parlet, MD
• Rylee Elise Diedrich
• Angela D Dolphin, PA-C
• Todd F Dolphin, DPM
• Kelly Donlon
• Douglas J Recker
• Leslie Kay Downs Mullen, MS. LMFT
• Dr. Stephen E. Broad DDS PC.

• All providers in Hiawatha, IA
• Pediatric Occupational Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; 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.