Lisa Sandstrom, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103330 Issued in MN

Practice address

6381 Osgood Ave N BLDG C
Stillwater, MN 55082-6118

Phone

(651) 238-0435

Fax

(651) 383-4544

NPI assigned

Jun 29, 2007

Last updated

Jun 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Lisa Sandstrom LLC

  dba Still Waters Occupational Therapy

  • Occupational Therapist
  • Stillwater, MN
  • NPI 1467875294
  Authorized official Same address or phone

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

{
    "created_epoch": "1183075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1467659839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9207 SAINT CROIX TRL N",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550824267",
            "telephone_number": "651-238-0435",
            "fax_number": "651-383-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6381 OSGOOD AVE N BLDG C",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826118",
            "telephone_number": "651-238-0435",
            "fax_number": "651-383-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDSTROM",
        "first_name": "LISA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-29",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103330",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "670000488",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.