Lori Eddy

Key facts

NPI

1891044103

Entity type

Individual (NPI type 1)

Primary specialty

Occupational Therapy Assistant 224Z00000X

License

492427 (WI)

Practice address

620 Grand View Ave
Blair, WI 54616

Phone

(608) 989-2195

Fax

(608) 989-2265

NPI assigned

Aug 31, 2012

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Aug 31, 2012.

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346371200000",
    "number": "1891044103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S HOLMEN DR",
            "address_2": "SUITE 2",
            "city": "HOLMEN",
            "state": "WI",
            "postal_code": "546369467",
            "telephone_number": "608-526-9888",
            "fax_number": "608-526-9965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 GRAND VIEW AVE",
            "city": "BLAIR",
            "state": "WI",
            "postal_code": "54616",
            "telephone_number": "608-989-2195",
            "fax_number": "608-989-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDDY",
        "first_name": "LORI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-31",
        "last_updated": "2012-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WI",
            "license": "492427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blair, WI

• Alexa Brenner
• Brian J Brost, DC
• County of Trempealeau
• CV Smith SC
• Cheryl A Dolsey, RN, BSN
• Ann Elizabeth Finstad, COTA/L
• Amber Frederixon
• Grand View Care Center Inc
• Gundersen Clinic, LTD.
• Michelle Halverson

All providers in Blair, WI · Occupational Therapy Assistant in Wisconsin