Nicole Lavanway, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057005551 Issued in IL

Practice address

1301 21St St
Peru, IL 61354-1359

Phone

(815) 223-4901

NPI assigned

Mar 31, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1326626334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N 1ST ST",
            "city": "PRINCETON",
            "state": "IL",
            "postal_code": "613561212",
            "telephone_number": "815-541-0431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 21ST ST",
            "city": "PERU",
            "state": "IL",
            "postal_code": "613541359",
            "telephone_number": "815-223-4901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVANWAY",
        "first_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057005551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph G. Kunnel, D.D.S., M.S., PHD.
• John T Kuzma, PA-C
• Allyson Lamkin, OD
• Angie Lamps, M.S.CCC-SLP
• Vanessa Langguth, PTA
• Christine Marie Layhew, DPT
• Joel S Leifheit, MD
• Melissa Lenhausen, RN, IBCLC
• Gynger Lentz, APRN
• Nancy A. Liesse

• Occupational Therapy Assistant in Peru, IL
• Providers in Peru, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.