Individual provider Active NPI

Lauren Elise Roberto, OTR/L

  • Occupational Therapist
  • Saint Louis, MO
National Provider Identifier
1376180984
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
2017030594 Issued in MO
Practice address
801 N 11TH St
Saint Louis, MO 63101-1015
Phone
(314) 231-3720
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 13421 MA
Occupational Therapist 225X00000X 2017030594 MO Primary

Addresses

Primary practice location

801 N 11TH St
Saint Louis, MO 63101-1015

Mailing address

6906 Waldemar Ave
Saint Louis, MO 63139-3538
Phone (224) 688-7562

Other identifiers 1

IdentifierTypeStateIssuer
13421OtherMAOCCUPATIONAL THERAPIST

Other names 1

  • Ms. Lauren Elise Olson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13421MAMDOccupational Therapist
2017030594MOMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1376180984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6906 WALDEMAR AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631393538",
            "telephone_number": "224-688-7562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 N 11TH ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631011015",
            "telephone_number": "314-231-3720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTO",
        "first_name": "LAUREN",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MA",
            "license": "13421",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MO",
            "license": "2017030594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST",
            "identifier": "13421",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAUREN",
            "last_name": "OLSON",
            "middle_name": "ELISE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.