Individual provider Active NPI

Lauren Elizabeth Laenen, MOT,OTR/L

  • Occupational Therapist
  • Pontotoc, MS
National Provider Identifier
1194338079
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2877 Issued in MS
Practice address
147 S Brooks St
Pontotoc, MS 38863-2950
Phone
(662) 489-4050
NPI assigned
Aug 28, 2020
Last updated
Aug 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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 2877 MS Primary

Addresses

Primary practice location

147 S Brooks St
Pontotoc, MS 38863-2950

Mailing address

981 Boland Loop
Pontotoc, MS 38863-6355
Phone (166) 226-6288

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250930001411 FL Practitioner - Occupational Therapist in Private Practice 9436655461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Action Therapy Group LLCGroup PAC ID 6305258013, 69 clinicians

Practice addresses (Care Compare)

1551 Merchants Way
Niceville, FL 32578-8830
Phone (850) 741-6715

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Action Therapy Group LLC CurrentSince Sep 1, 2025 Accepting new patients

Locations

3964 Florida Ave
Jay, FL 32565
Phone (850) 675-4000

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1194338079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 BOLAND LOOP",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388636355",
            "telephone_number": "166-226-6288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 S BROOKS ST",
            "city": "PONTOTOC",
            "state": "MS",
            "postal_code": "388632950",
            "telephone_number": "662-489-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAENEN",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "credential": "MOT,OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MS",
            "license": "2877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontotoc, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2020; 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.