Lori Jo Bansemer, MS.OTR,CHT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1389-026 Issued in WI

Practice address

709 Spring Valley Rd
Burlington, WI 53105-3622

Phone

(262) 971-9314

Fax

(262) 971-9301

NPI assigned

Aug 16, 2007

Last updated

Oct 31, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lori Jo Heinzen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477872000000",
    "number": "1619169265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 SPRING VALLEY RD",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531057614",
            "telephone_number": "262-971-9314",
            "fax_number": "262-971-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 SPRING VALLEY RD",
            "city": "BURLINGTON",
            "state": "WI",
            "postal_code": "531053622",
            "telephone_number": "262-971-9314",
            "fax_number": "262-971-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANSEMER",
        "first_name": "LORI",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "MS.OTR,CHT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2016-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "1389-026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "HEINZEN",
            "middle_name": "JO",
            "credential": "OTR",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laura Axelson
• Rebecca Lynn Baade, SLP
• Jeffrey W Bailet, MD
• Casey Balkowski
• Kathryn Lynnae Ballweg, M.S. CCC-SLP
• Brianna Barker, APNP
• Susan M Barr, PA
• Lili Barsky, MD
• Brielle Bartes
• William Henry Basil, DDS

• Occupational Therapist in Burlington, WI
• Providers in Burlington, WI by specialty
• Occupational Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.