Individual provider Active NPI

Julianna Wittrup, OTR/L

  • Occupational Therapist
  • Nome, AK
National Provider Identifier
1952805590
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT.0004576 Issued in CO
Practice address
1000 Greg Kruschek Avenue
Nome, AK 99762-0966
Phone
(907) 443-3311
NPI assigned
Mar 20, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT.60913624 WA
Occupational Therapist 225X00000X OT.16182 CA
Occupational Therapist 225X00000X OT.0004576 CO Primary

Addresses

Primary practice location

1000 Greg Kruschek Avenue
Nome, AK 99762-0966

Mailing address

11830 N 75TH St Unit 384
Hygiene, CO 80533-7417
Phone (808) 359-3374

Other names 1

  • Lisa J Wittrup Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250817000047 AK Practitioner - Occupational Therapist in Private Practice 8729338066 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 Greg Kruschek Ave
Nome, AK 99762-0966

PO Box
Suite 966
Nome, AK 99762-0966

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4576COMDFamily Medicine Physician
OT.16182CAMDOccupational Therapist
OT.0004576COMDOccupational Therapist
OT.60913624WAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Norton Sound Health Corporation CurrentSince Jun 9, 2025 Accepting new patients
Thrive Rehab, PLLC CurrentSince Nov 13, 2022 Accepting new patients
Norton Sound Health Corporation CurrentSince Jun 9, 2025 Accepting new patients
Oncology Rehab Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1952805590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11830 N 75TH ST UNIT 384",
            "city": "HYGIENE",
            "state": "CO",
            "postal_code": "805337417",
            "telephone_number": "808-359-3374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 GREG KRUSCHEK AVENUE",
            "city": "NOME",
            "state": "AK",
            "postal_code": "997620966",
            "telephone_number": "907-443-3311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTRUP",
        "first_name": "JULIANNA",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-20",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT.60913624",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT.16182",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "OT.0004576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WITTRUP",
            "middle_name": "J",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Nome, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.