Individual provider Active NPI

Lauren Ploeg, OT

  • Occupational Therapist
  • South Bend, IN
National Provider Identifier
1225749252
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31007362A Issued in IN
Practice address
4010 S Ironwood Dr
South Bend, IN 46614-2200
Phone
(574) 291-2222
Fax
(317) 708-6496
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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 31007362A IN Primary

Addresses

Primary practice location

4010 S Ironwood Dr
South Bend, IN 46614-2200

Mailing address

2416 Elizabeth St
Niles, MI 49120-7709
Phone (269) 313-2353

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221228000738 IN Practitioner - Occupational Therapist in Private Practice 8628448156 Reassigns benefits to 2 organizations
I20260520003776 SC Practitioner - Occupational Therapist in Private Practice 8628448156 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

343 E 90TH Dr
Merrillville, IN 46410-8152
Phone (219) 207-6100

4010 S Ironwood Dr
Vertis Therapy|Grand Emerald
South Bend, IN 46614-2200
Phone (574) 216-4510

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31007362AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Sep 14, 2024 Accepting new patients
Creative Health Care Management LLC Occupational Therapist CurrentSince Dec 1, 2022 Accepting new patients
Creative Health Care Management LLC Occupational Therapist CurrentSince Dec 1, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Occupational Therapist CurrentSince Sep 14, 2024 Accepting new patients

Locations

300 E Washington Blvd
Fort Wayne, IN 46802
Phone (260) 422-5511

1540 S Logan St
Mishawaka, IN 46544
Phone (574) 207-0833

10 S 9th St
Ste 4
Noblesville, IN 46060

Organizations & group practices 5

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": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1225749252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2416 ELIZABETH ST",
            "city": "NILES",
            "state": "MI",
            "postal_code": "491207709",
            "telephone_number": "269-313-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 S IRONWOOD DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142200",
            "telephone_number": "574-291-2222",
            "fax_number": "317-708-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOEG",
        "first_name": "LAUREN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31007362A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.