Provider Demographics
NPI:1518962695
Name:LOTT, ROSEMARY (PT)
Entity Type:Individual
Prefix:MRS
First Name:ROSEMARY
Middle Name:
Last Name:LOTT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4406 NW MESA CT
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66618-3253
Mailing Address - Country:US
Mailing Address - Phone:785-246-0651
Mailing Address - Fax:785-271-8818
Practice Address - Street 1:5220 SW 17TH ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-2459
Practice Address - Country:US
Practice Address - Phone:785-271-5533
Practice Address - Fax:785-271-8818
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2017-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
KS11-008462251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
140883OtherBLUE CROSS
140883Medicare ID - Type Unspecified