Individual provider Active NPI

Lani Rasley Stockwell, OTD, OTR/L

  • Occupational Therapist
  • Herndon, VA
National Provider Identifier
1730249822
Registry record updated Jun 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
0119004242 Issued in VA
Practice address
171 Elden St Ste 2C4
Herndon, VA 20170-4875
Phone
(703) 481-5801
Fax
(703) 481-5804
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2014

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 0119004242 VA Primary

Addresses

Primary practice location

171 Elden St Ste 2C4
Herndon, VA 20170-4875

Mailing address

171 Elden St Ste 2C4
Herndon, VA 20170-4875
Phone (703) 481-5801

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221011002214 WI Practitioner - Occupational Therapist in Private Practice 0547636854 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Paxxon Healthcare Services LLCGroup PAC ID 8325959554, 153 clinicians

Practice addresses (Care Compare)

1111 E Capitol Dr
Shorewood, WI 53211-1810
Phone (414) 312-8146

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0119004242VAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Paxxon Healthcare Services LLC Occupational Therapist CurrentSince Sep 12, 2022 Accepting new patients
Paxxon Healthcare Services LLC Occupational Therapist CurrentSince Sep 12, 2022 Accepting new patients

Locations

1111 E Capitol Dr
Shorewood, WI 53211
Phone (262) 293-3207

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401840000000",
    "number": "1730249822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 ELDEN ST STE 2C4",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704875",
            "telephone_number": "703-481-5801",
            "fax_number": "703-481-5804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ELDEN ST STE 2C4",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201704875",
            "telephone_number": "703-481-5801",
            "fax_number": "703-481-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKWELL",
        "first_name": "LANI",
        "middle_name": "RASLEY",
        "name_prefix": "Dr.",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2014-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "VA",
            "license": "0119004242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herndon, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2014; 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.