Individual provider Active NPI

Laura Beth Weir, OTR/L

  • Pediatric Occupational Therapist
  • Maplewood, MN
National Provider Identifier
1508109513
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
104438 Issued in MN
Practice address
2495 Maplewood Dr
Suite 313
Maplewood, MN 55109-1984
Phone
(651) 770-8884
Fax
(651) 770-8151
NPI assigned
Mar 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 104438 MN Primary

Addresses

Primary practice location

2495 Maplewood Dr
Suite 313
Maplewood, MN 55109-1984

Mailing address

2495 Maplewood Dr
Suite 313
Maplewood, MN 55109-1984
Phone (651) 770-8884

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130429000398 MN Practitioner - Occupational Therapist in Private Practice 5597901033 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Integrated Therapy, LTD CurrentSince Apr 15, 2013 Accepting new patients

Locations

2495 Maplewood Dr N
Ste 313
Maplewood, MN 55109
Phone (651) 770-8884

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1508109513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR",
            "address_2": "SUITE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091984",
            "telephone_number": "651-770-8884",
            "fax_number": "651-770-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 MAPLEWOOD DR",
            "address_2": "SUITE 313",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091984",
            "telephone_number": "651-770-8884",
            "fax_number": "651-770-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEIR",
        "first_name": "LAURA",
        "middle_name": "BETH",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-28",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "104438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.