Individual provider Active NPI

Lauren Witsaman, OTR

  • Occupational Therapist
  • St Petersburg, FL
National Provider Identifier
1114497856
Registry record updated Sep 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT19866 Issued in FL
Practice address
5101 Brittany Dr S Ste 16
Saint Petersburg, FL 33715-1565
Phone
(727) 308-9848
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 084581 MI
Occupational Therapist 225X00000X OT19866 FL Primary

Addresses

Primary practice location

5101 Brittany Dr S Ste 16
Saint Petersburg, FL 33715-1565

Mailing address

215 York View CT NW
Comstock Park, MI 49321-8926
Phone (616) 901-0073

Other practice location 1

215 York View Ct NW
Comstock Park, MI 49321-8926
Phone (616) 901-0073

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191008002378 FL Practitioner - Occupational Therapist in Private Practice 1052642907 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Empowerme Rehabilitation Florida, LLCGroup PAC ID 3274962790, 151 clinicians

Practice addresses (Care Compare)

3400 SE Aster LN
Empowerme Rehabilitation Stuart
Stuart, FL 34994-5516
Phone (877) 367-9772

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
084581MIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empowerme Rehabilitation Florida, LLC CurrentSince Mar 22, 2022 Accepting new patients
Empowerme Rehabilitation Florida, LLC CurrentSince Mar 22, 2022 Accepting new patients

Locations

5101 Brittany Dr S
Ste 16
St Petersburg, FL 33715
Phone (407) 538-2589

1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723

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": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1114497856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 YORK VIEW CT NW",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493218926",
            "telephone_number": "616-901-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5101 BRITTANY DR S STE 16",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337151565",
            "telephone_number": "727-308-9848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "215 York View Ct NW",
            "address_purpose": "LOCATION",
            "city": "Comstock Park",
            "state": "MI",
            "postal_code": "493218926",
            "country_code": "US",
            "telephone_number": "616-901-0073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITSAMAN",
        "first_name": "LAUREN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "084581",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT19866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.