Lisa C Neitge, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

101780 Issued in MN

Practice address

3305 Central Park Village Dr Ste 130
Eagan, MN 55121-7707

Phone

(651) 406-8868

NPI assigned

Jul 23, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1841490224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 E TAYLOR ST",
            "city": "PRAIRIE DU CHIEN",
            "state": "WI",
            "postal_code": "538212110",
            "telephone_number": "608-357-2000",
            "fax_number": "608-357-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 CENTRAL PARK VILLAGE DR STE 130",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551217707",
            "telephone_number": "651-406-8868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 E Taylor St",
            "address_purpose": "LOCATION",
            "city": "Prairie Du Chien",
            "state": "WI",
            "postal_code": "538212110",
            "country_code": "US",
            "telephone_number": "608-357-2000 x2401",
            "fax_number": "608-357-2254",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEITGE",
        "first_name": "LISA",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "3914026",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "101780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41047800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Occupational Therapist in Eagan, MN
• Providers in Eagan, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2020; 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.