Individual provider Active NPI

Lori J Grandy, OTR

  • Occupational Therapist
  • Indianapolis, IN
National Provider Identifier
1356417588
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31001096A Issued in IN
Practice address
4850 Century Plaza Rd
Indianapolis, IN 46254-5476
Phone
(317) 216-2828
Fax
(317) 216-2839
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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 31001096A IN Primary

Addresses

Primary practice location

4850 Century Plaza Rd
Indianapolis, IN 46254-5476

Mailing address

4850 W Century Plaza Rd
Indianapolis, IN 46254
Phone (317) 216-2828

Other practice location 1

10940 E US Highway 36
Avon, IN 46123-7980
Phone (317) 808-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190220001924 IN Practitioner - Occupational Therapist in Private Practice 4284972019 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
Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

3105 S Western Ave
Athletico Physical Therapy
Marion, IN 46953-3966
Phone (765) 733-0050

Merit-based Incentive Payment System (MIPS)

Final score
86.32 of 100Reported as group
Quality
84.44
Promoting interoperability
99
Improvement activities
40
Cost
70.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31001096AINMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Athletico, LTD Occupational Therapist CurrentSince Feb 11, 2019 Accepting new patients
Athletico LTD Current Accepting new patients
Athletico LTD Occupational Therapist CurrentSince Feb 11, 2019 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

10940 E US Highway 36
Avon, IN 46123
Phone (317) 808-7000

3229 Broadway
Gary, IN 46409
Phone (219) 326-2324

3105 S Western Ave
Marion, IN 46953
Phone (765) 651-8480

1505 US Highway 41
Ste A20
Schererville, IN 46375
Phone (219) 322-5560

Organizations & group practices 3

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": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1356417588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 W CENTURY PLAZA RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46254",
            "telephone_number": "317-216-2828",
            "fax_number": "317-216-2839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 CENTURY PLAZA RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545476",
            "telephone_number": "317-216-2828",
            "fax_number": "317-216-2839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10940 E US Highway 36",
            "address_purpose": "LOCATION",
            "city": "Avon",
            "state": "IN",
            "postal_code": "461237980",
            "country_code": "US",
            "telephone_number": "317-808-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANDY",
        "first_name": "LORI",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31001096A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 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.