Paige Van Lanen, COTA/L

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

480887

Practice address

16258 Kenyon Ave
Lakeville, MN 55044-4665

Phone

(952) 915-1515

NPI assigned

Dec 29, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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": "1672272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1710690300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 SAINT FRANCIS WAY APT E",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551231168",
            "telephone_number": "651-328-9871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16258 KENYON AVE",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550444665",
            "telephone_number": "952-915-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN LANEN",
        "first_name": "PAIGE",
        "credential": "COTA/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-29",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "202732",
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": "480887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shamso Mohamud Ulusow
• Sydney Ann Ungar, PA-C
• Upright Health PLLC
• Ethan T Urtel
• Shaida Vafaei, MA
• Kelly Dee Vancleve
• Shana Vande Zande
• Christopher Vandergriff, DPT
• Melissa Catherine Vandermause, PHARMD
• Pearl Pajdawb Vang

• Occupational Therapy Assistant in Lakeville, MN
• Providers in Lakeville, MN by specialty
• Occupational Therapy Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 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.