Individual provider Active NPI

Douglas J Lauber, OTR/L,CHT

  • Hand Occupational Therapist
  • Clemson, SC
National Provider Identifier
1669569190
Registry record updated Jul 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
1051100620 Issued in SC
Practice address
501 Forest LN
Suite a
Clemson, SC 29631-2621
Phone
(864) 654-2001
Fax
(800) 305-7112
NPI assigned
Oct 6, 2006
Last updated
Jul 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 2970 SC
Hand Occupational Therapist 225XH1200X 1051100620 SC Primary

Addresses

Primary practice location

501 Forest LN
Suite a
Clemson, SC 29631-2621

Mailing address

501 Forest LN
Suite a
Clemson, SC 29631-2621
Phone (864) 654-2001

Other identifiers 1

IdentifierTypeStateIssuer
TH1874MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070710000022 SC Practitioner - Occupational Therapist in Private Practice 4385744184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Rehabilitation and SportsGroup PAC ID 1759481559, 53 clinicians

Practice addresses (Care Compare)

11091 N Radio Station Rd
Seneca, SC 29678-1142
Phone (864) 654-2001

1664 E Main St
Easley, SC 29640-3790
Phone (864) 654-2001

501 Forest LN
Suite a
Clemson, SC 29631-2621
Phone (864) 654-2001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2970SCMDGeneral Practice Dentistry
1051100620SCMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Rehabilitation and Sports Occupational Therapist CurrentSince Jun 6, 2007 Accepting new patients
Excel Rehabilitation and Sports CurrentSince Jun 6, 2007 Accepting new patients

Locations

501 Forest Ln
Ste A
Clemson, SC 29631
Phone (864) 654-2001

1664 E Main St
Easley, SC 29640
Phone (864) 654-2001

103 Halton Rd
#B
Greenville, SC 29607
Phone (864) 336-8599

11091 N Radio Station Rd
Seneca, SC 29678
Phone (864) 654-2001

Organizations & group practices 2

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": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469577600000",
    "number": "1669569190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 FOREST LN",
            "address_2": "SUITE A",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312621",
            "telephone_number": "864-654-2001",
            "fax_number": "800-305-7112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 FOREST LN",
            "address_2": "SUITE A",
            "city": "CLEMSON",
            "state": "SC",
            "postal_code": "296312621",
            "telephone_number": "864-654-2001",
            "fax_number": "800-305-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUBER",
        "first_name": "DOUGLAS",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "OTR/L,CHT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2016-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "2970",
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "SC",
            "license": "1051100620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH1874",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemson, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.