Individual provider Active NPI

Lavonne Susan Schmitt, OTR

  • Occupational Therapist
  • Blaine, MN
National Provider Identifier
1508568510
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
100561 Issued in MN
Practice address
807 103Rd Ave NE
Blaine, MN 55434-4536
Phone
(763) 360-2454
NPI assigned
Mar 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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 100561 MN Primary

Addresses

Primary practice location

807 103Rd Ave NE
Blaine, MN 55434-4536

Mailing address

807 103Rd Ave NE
Blaine, MN 55434-4536
Phone (763) 360-2454

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
100561MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ascend Rehab, LLC CurrentSince Aug 14, 2024 Accepting new patients

Locations

1660 Highway 100 S
Ste 103
St Louis Park, MN 55416
Phone (952) 283-2206

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1508568510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 103RD AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344536",
            "telephone_number": "763-360-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 103RD AVE NE",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554344536",
            "telephone_number": "763-360-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMITT",
        "first_name": "LAVONNE",
        "middle_name": "SUSAN",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "100561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.