Individual provider Active NPI

Lori Katherine Ehmann, OTR

  • Pediatric Occupational Therapist
  • Port Orange, FL
National Provider Identifier
1811199482
Registry record updated Dec 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT12383 Issued in FL
Practice address
900 N Swallow Tail Dr Ste 107
Port Orange, FL 32129-6103
Phone
(386) 446-9935
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT12383 FL Primary

Addresses

Primary practice location

900 N Swallow Tail Dr Ste 107
Port Orange, FL 32129-6103

Mailing address

101 Ocean Way Dr
Ponce Inlet, FL 32127-7321
Phone (386) 295-6561

Other names 1

  • Lori Micke Former name

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
OT12383FLMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1811199482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 OCEAN WAY DR",
            "city": "PONCE INLET",
            "state": "FL",
            "postal_code": "321277321",
            "telephone_number": "386-295-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N SWALLOW TAIL DR STE 107",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296103",
            "telephone_number": "386-446-9935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EHMANN",
        "first_name": "LORI",
        "middle_name": "KATHERINE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "FL",
            "license": "OT12383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "MICKE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Port Orange, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.