Active NPI
Joan Ellen Lilly, OTR/L CLWT
- Occupational Therapist
- Creighton, NE
National Provider Identifier
1972083889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1066
- Practice address
- 1503 Main St
Creighton, NE 68729-3007 - Phone
- (402) 358-5759
- NPI assigned
- Aug 20, 2018
- Last updated
- Aug 20, 2018
- 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 | 1066 | NE | Primary |
Addresses
Primary practice location
1503 Main St
Creighton, NE 68729-3007
Mailing address
1603 Bryant Ave
Creighton, NE 68729-2966
Phone (402) 358-0081
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 |
|---|---|---|---|
| 1066 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1972083889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1603 BRYANT AVE",
"city": "CREIGHTON",
"state": "NE",
"postal_code": "687292966",
"telephone_number": "402-358-0081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1503 MAIN ST",
"city": "CREIGHTON",
"state": "NE",
"postal_code": "687293007",
"telephone_number": "402-358-5759"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLY",
"first_name": "JOAN",
"middle_name": "ELLEN",
"credential": "OTR/L CLWT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-20",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NE",
"license": "1066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Creighton, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.