Active NPI
Michelle Lillicrap, OTR
- Occupational Therapist
- Saint Paul, MN
National Provider Identifier
1386980126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 103003
- Practice address
- 1415 Almond Ave
Saint Paul, MN 55108-2507 - Phone
- (952) 955-2242
- Fax
- (952) 955-2010
- NPI assigned
- Dec 26, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 103003 | MN | Primary |
Addresses
Primary practice location
1415 Almond Ave
Saint Paul, MN 55108-2507
Mailing address
200 Lewis Ave S
Suite 210
Watertown, MN 55388-4545
Phone (952) 955-2242
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
| License | State | Type | Specialty |
|---|---|---|---|
| 103003 | MN | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356480000000",
"number": "1386980126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 LEWIS AVE S",
"address_2": "SUITE 210",
"city": "WATERTOWN",
"state": "MN",
"postal_code": "553884545",
"telephone_number": "952-955-2242",
"fax_number": "952-955-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1415 ALMOND AVE",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551082507",
"telephone_number": "952-955-2242",
"fax_number": "952-955-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LILLICRAP",
"first_name": "MICHELLE",
"credential": "OTR",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-26",
"last_updated": "2012-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "103003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.