Individual provider Active NPI

Lanette M Johnson, OTR

  • Occupational Therapist
  • Osceola, WI
National Provider Identifier
1417126400
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4827-26 Issued in WI
Practice address
2600 65TH Avenue
Osceola, WI 54020-4370
Phone
(715) 294-2111
Fax
(715) 294-5758
NPI assigned
Feb 25, 2008
Last updated
Nov 25, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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 4827-26 WI Primary
Occupational Therapist 225X00000X 1961-026 WI

Addresses

Primary practice location

2600 65TH Avenue
Osceola, WI 54020-4370

Mailing address

PO Box 860912
Minneapolis, MN 55486-0912
Phone (715) 838-5222

Other practice location 1

1501 Thompson St
Bloomer, WI 54724-1257
Phone (715) 838-5222

Other names 1

  • Miss Lanette M Raffesberger Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ljohnson2588445@ehrdirect.mayoclinicmsg.org

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251208003649 WI Practitioner - Occupational Therapist in Private Practice 3971097908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1992
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Minneapolis, MN 55486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4827-26WIMDOrthopedic Physical Therapist
1961-026WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Nov 24, 2025 Accepting new patients
Mayo Clinic Health System-Northwest Wisconsin Region, Inc. CurrentSince Nov 24, 2025 Accepting new patients

Locations

1501 Thompson St
Bloomer, WI 54724
Phone (715) 568-2000

733 W Clairemont Ave
Eau Claire, WI 54701
Phone (715) 838-3806

Organizations & group practices 2

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": "1203897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1417126400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912",
            "telephone_number": "715-838-5222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 65TH AVENUE",
            "city": "OSCEOLA",
            "state": "WI",
            "postal_code": "540204370",
            "telephone_number": "715-294-2111",
            "fax_number": "715-294-5758"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Thompson St",
            "address_purpose": "LOCATION",
            "city": "Bloomer",
            "state": "WI",
            "postal_code": "547241257",
            "country_code": "US",
            "telephone_number": "715-838-5222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LANETTE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-25",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4827-26",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1961-026",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ljohnson2588445@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "1501 Thompson St",
            "city": "Bloomer",
            "state": "WI",
            "country_code": "US",
            "postal_code": "547241257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LANETTE",
            "last_name": "RAFFESBERGER",
            "middle_name": "M",
            "prefix": "MISS",
            "credential": "O.T.R.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Osceola, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2025; 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.