Individual provider Active NPI

Rachael Burgess Lutz, MOT, OTR

  • Occupational Therapist
  • Austin, TX
National Provider Identifier
1558880716
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
389304 Issued in TX
Practice address
7801 N Lamar Blvd Ste A114
Austin, TX 78752-1049
Phone
(512) 646-4673
Fax
(512) 729-0320
NPI assigned
Sep 19, 2017
Last updated
Apr 8, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 118583 TX
Occupational Therapist 225X00000X 21311 CA
Occupational Therapist 225X00000X 389304 TX Primary

Addresses

Primary practice location

7801 N Lamar Blvd Ste A114
Austin, TX 78752-1049

Mailing address

7801 N Lamar Blvd Ste A114
Austin, TX 78752-1049
Phone (512) 646-4673

Other practice location 1

11840 S La Cienega Blvd
Hawthorne, CA 90250-3459
Phone (424) 269-3400

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
389304TXMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
S. Potts and Professionals, Inc. PastSince Oct 19, 2020 Accepting new patients

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": "1505779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1558880716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7801 N LAMAR BLVD STE A114",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787521049",
            "telephone_number": "512-646-4673",
            "fax_number": "512-729-0320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7801 N LAMAR BLVD STE A114",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787521049",
            "telephone_number": "512-646-4673",
            "fax_number": "512-729-0320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11840 S La Cienega Blvd",
            "address_purpose": "LOCATION",
            "city": "Hawthorne",
            "state": "CA",
            "postal_code": "902503459",
            "country_code": "US",
            "telephone_number": "424-269-3400",
            "fax_number": "310-882-5451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTZ",
        "first_name": "RACHAEL",
        "middle_name": "BURGESS",
        "credential": "MOT, OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-19",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "118583",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "21311",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "389304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.