Individual provider Active NPI

Lori Wagner, OTR/L

  • Occupational Therapist
  • Toledo, OH
National Provider Identifier
1366936528
Registry record updated Feb 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT006019 Issued in OH
Practice address
7150 Granite Cir
Toledo, OH 43617-3113
Phone
(419) 843-6002
NPI assigned
Jun 20, 2018
Last updated
Feb 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 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 OT006019 OH Primary

Addresses

Primary practice location

7150 Granite Cir
Toledo, OH 43617-3113

Mailing address

35251 Saddle CRK
Avon, OH 44011-4914

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220317002734 OH Practitioner - Occupational Therapist in Private Practice 5799170312 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Engage Wellness LLC Occupational Therapist CurrentSince Mar 1, 2022 Accepting new patients
Engage Wellness LLC Occupational Therapist CurrentSince Mar 1, 2022 Accepting new patients
Concept Rehab, Inc PastSince Feb 13, 2022 Accepting new patients

Locations

6591 W Central Ave
Ste 105
Toledo, OH 43617
Phone (419) 345-7645

7150 Granite Cir
Ste 200
Toledo, OH 43617
Phone (419) 345-7645

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, 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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1366936528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35251 SADDLE CRK",
            "city": "AVON",
            "state": "OH",
            "postal_code": "440114914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7150 GRANITE CIR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436173113",
            "telephone_number": "419-843-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGNER",
        "first_name": "LORI",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "OH",
            "license": "OT006019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.