Individual provider Active NPI

Laura Jean Dickason-Sopeth, OTR

  • Occupational Therapist
  • Savage, MN
National Provider Identifier
1104624550
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
100665 Issued in MN
Practice address
8758 Egan Dr
Savage, MN 55378-2561
Phone
(952) 473-9888
NPI assigned
Mar 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 100665 MN Primary

Addresses

Primary practice location

8758 Egan Dr
Savage, MN 55378-2561

Mailing address

17420 Ixonia CT
Lakeville, MN 55044-8741
Phone (612) 280-3514

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250313000871 MN Practitioner - Occupational Therapist in Private Practice 4284155763 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100665MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kid Talk Inc CurrentSince Mar 10, 2025 Accepting new patients
Kid Talk Inc CurrentSince Mar 10, 2025 Accepting new patients

Locations

8758 Egan Dr
Savage, MN 55378
Phone (952) 226-2999

1772 Stieger Lake Ln
Victoria, MN 55386
Phone (952) 443-9888

Organizations & group practices 2

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": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1104624550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17420 IXONIA CT",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550448741",
            "telephone_number": "612-280-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8758 EGAN DR",
            "city": "SAVAGE",
            "state": "MN",
            "postal_code": "553782561",
            "telephone_number": "952-473-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DICKASON-SOPETH",
        "first_name": "LAURA",
        "middle_name": "JEAN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "100665",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savage, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.