Active NPI
Lisa Ann Thibodeau, MED, MSOT, OTR
- Occupational Therapist
- Walpole, MA
National Provider Identifier
1861272957
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- OTL14999
- Practice address
- 399 Lincoln Rd
Walpole, MA 02081-1218 - Phone
- (617) 233-5441
- NPI assigned
- Oct 5, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | OT02214 | RI | |
| Occupational Therapist | 225X00000X | OTL14999 | MA | Primary |
Addresses
Primary practice location
399 Lincoln Rd
Walpole, MA 02081-1218
Mailing address
623 Hilltop Dr
Walpole, MA 02081-4410
Phone (617) 233-5441
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OTL14999 | MA | MD | Occupational Therapist |
| OT02214 | RI | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1696464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696464000000",
"number": "1861272957",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "623 HILLTOP DR",
"city": "WALPOLE",
"state": "MA",
"postal_code": "020814410",
"telephone_number": "617-233-5441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "399 LINCOLN RD",
"city": "WALPOLE",
"state": "MA",
"postal_code": "020811218",
"telephone_number": "617-233-5441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THIBODEAU",
"first_name": "LISA",
"middle_name": "ANN",
"credential": "MED, MSOT, OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-05",
"last_updated": "2023-10-05",
"certification_date": "2023-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "RI",
"license": "OT02214",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "OTL14999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walpole, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.