Active NPI
Lisa M Withers, OT
- Occupational Therapist
- Saint Louis, MO
National Provider Identifier
1861418006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 005365
- Practice address
- 4444 Forest Park Ave
Saint Louis, MO 63108-2212 - Phone
- (314) 286-1600
- Fax
- (314) 286-1601
- NPI assigned
- Jul 14, 2006
- 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 | 005365 | MO | Primary |
Addresses
Primary practice location
4444 Forest Park Ave
Saint Louis, MO 63108-2212
Mailing address
7425 Forsyth
C B 8221
Saint Louis, MO 63105-2161
Phone (314) 286-1600
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200268800000",
"number": "1861418006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7425 FORSYTH",
"address_2": "C B 8221",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631052161",
"telephone_number": "314-286-1600",
"fax_number": "314-286-1601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4444 FOREST PARK AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082212",
"telephone_number": "314-286-1600",
"fax_number": "314-286-1601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITHERS",
"first_name": "LISA",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-14",
"last_updated": "2008-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MO",
"license": "005365",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.