Active NPI
Terri Lacey, OT
- Occupational Therapist
- Show Low, AZ
National Provider Identifier
1942619150
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 5530
- Practice address
- 1294 Fawn Brook Dr
Show Low, AZ 85901-7654 - Phone
- (951) 295-5275
- NPI assigned
- Aug 13, 2014
- Last updated
- Aug 13, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 5530 | AZ | Primary |
Addresses
Primary practice location
1294 Fawn Brook Dr
Show Low, AZ 85901-7654
Mailing address
HC 30 Box 9E
Concho, AZ 85924-9309
Phone (951) 295-5275
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 |
|---|---|---|---|
| 5530 | AZ | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407888000000",
"number": "1942619150",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "HC 30 BOX 9E",
"city": "CONCHO",
"state": "AZ",
"postal_code": "859249309",
"telephone_number": "951-295-5275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1294 FAWN BROOK DR",
"city": "SHOW LOW",
"state": "AZ",
"postal_code": "859017654",
"telephone_number": "951-295-5275"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LACEY",
"first_name": "TERRI",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-08-13",
"last_updated": "2014-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "5530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Show Low, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.