Individual provider Active NPI

Debra Brinegar Lister, OTR/L

  • Occupational Therapist
  • Sun City West, AZ
National Provider Identifier
1851645105
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
7463 Issued in AZ
Practice address
14418 W Meeker Blvd Ste 301
Sun City West, AZ 85375-5292
Phone
(623) 888-3450
Fax
(480) 795-6157
NPI assigned
Nov 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 7463 AZ Primary
Occupational Therapist 225X00000X OT-1156 ID

Addresses

Primary practice location

14418 W Meeker Blvd Ste 301
Sun City West, AZ 85375-5292

Mailing address

25063 N 67TH Dr
Peoria, AZ 85383-7103
Phone (217) 369-7932

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dlister@banner-ptrehab.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7463AZMDOccupational Therapist
OT-1156IDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1352246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1851645105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25063 N 67TH DR",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853837103",
            "telephone_number": "217-369-7932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14418 W MEEKER BLVD STE 301",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755292",
            "telephone_number": "623-888-3450",
            "fax_number": "480-795-6157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISTER",
        "first_name": "DEBRA",
        "middle_name": "BRINEGAR",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-07",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "7463",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ID",
            "license": "OT-1156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dlister@banner-ptrehab.com",
            "affiliation": "N",
            "endpointDescription": "work email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "14418 W Meeker Blvd Ste 301",
            "city": "Sun City West",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "853755292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; 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.