Active NPI
Larissa Lynn Whittenburg, OTR/L, CLC
- Occupational Therapist
- Colorado City, TX
National Provider Identifier
1861201477
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 120683
- Practice address
- 1132 Hickory St
Colorado City, TX 79512-4912 - Phone
- (325) 728-5312
- NPI assigned
- Jan 7, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 120683 | TX | Primary |
Addresses
Primary practice location
1132 Hickory St
Colorado City, TX 79512-4912
Mailing address
1210 State Highway 70
Sweetwater, TX 79556-1728
Phone (325) 725-8338
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120683 | TX | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736208000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736208000000",
"number": "1861201477",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1210 STATE HIGHWAY 70",
"city": "SWEETWATER",
"state": "TX",
"postal_code": "795561728",
"telephone_number": "325-725-8338"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1132 HICKORY ST",
"city": "COLORADO CITY",
"state": "TX",
"postal_code": "795124912",
"telephone_number": "325-728-5312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITTENBURG",
"first_name": "LARISSA",
"middle_name": "LYNN",
"name_prefix": "Mrs.",
"credential": "OTR/L, CLC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-07",
"last_updated": "2025-01-07",
"certification_date": "2025-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TX",
"license": "120683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colorado City, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.