Individual provider Active NPI

Lydia Ann Houle, OT

  • Occupational Therapist
  • Bloomington, MN
National Provider Identifier
1407617749
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107371 Issued in MN
Practice address
4801 W 81St St Ste 112
Bloomington, MN 55437-1111
Phone
(952) 345-3000
Fax
(952) 345-6789
NPI assigned
Jan 23, 2024
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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 107371 MN Primary

Addresses

Primary practice location

4801 W 81St St Ste 112
Bloomington, MN 55437-1111

Mailing address

4801 W 81St St Ste 112
Bloomington, MN 55437-1111
Phone (952) 345-3000

Other practice location 1

1630 101st Ave NE Ste 160
Blaine, MN 55449-3403
Phone (952) 345-3000

Other practice location 2

7650 Currell Blvd Ste 260
Woodbury, MN 55125-8209
Phone (952) 345-3000

Other practice location 3

162 Cobblestone Ln
Burnsville, MN 55337-4578
Phone (952) 345-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216000043 MN Practitioner - Occupational Therapist in Private Practice 5799129854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
University of Minnesota Medical School, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
National Dizzy and Balance Center,LTD.Group PAC ID 7315983954, 29 clinicians

Practice addresses (Care Compare)

4801 W 81St St
Suite 112
Bloomington, MN 55437-1111
Phone (952) 345-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
National Dizzy & Balance Center,LTD. CurrentSince Jan 26, 2024 Accepting new patients

Locations

1630 101st Ave NE
Ste 160
Blaine, MN 55449
Phone (763) 786-6900

162 Cobblestone Ln
Burnsville, MN 55337
Phone (952) 345-3000

4801 W 81st St
Ste 112
Minneapolis, MN 55437
Phone (952) 345-3000

7650 Currell Blvd
Ste 260
Woodbury, MN 55125
Phone (952) 345-3000

Organizations & group practices 1

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": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1407617749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 W 81ST ST STE 112",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371111",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 W 81ST ST STE 112",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554371111",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1630 101st Ave NE Ste 160",
            "address_purpose": "LOCATION",
            "city": "Blaine",
            "state": "MN",
            "postal_code": "554493403",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7650 Currell Blvd Ste 260",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "MN",
            "postal_code": "551258209",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "162 Cobblestone Ln",
            "address_purpose": "LOCATION",
            "city": "Burnsville",
            "state": "MN",
            "postal_code": "553374578",
            "country_code": "US",
            "telephone_number": "952-345-3000",
            "fax_number": "952-345-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOULE",
        "first_name": "LYDIA",
        "middle_name": "ANN",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.