Individual provider Active NPI

Heidi Sara Lagasse, COTA/L

  • Occupational Therapy Assistant
  • Little River, SC
National Provider Identifier
1861738650
Registry record updated Dec 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
3147 Issued in SC
Practice address
241 Turquoise Cir
Little River, SC 29566-8131
Phone
(860) 944-7682
NPI assigned
Dec 24, 2012
Last updated
Dec 24, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 3147 SC Primary
Occupational Therapy Assistant 224Z00000X 000193 CT

Addresses

Primary practice location

241 Turquoise Cir
Little River, SC 29566-8131

Mailing address

241 Turquoise Cir
Little River, SC 29566-8131
Phone (860) 944-7682

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
3147SCMDOccupational Therapy Assistant
000193CTMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1356307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356307200000",
    "number": "1861738650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 TURQUOISE CIR",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295668131",
            "telephone_number": "860-944-7682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 TURQUOISE CIR",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295668131",
            "telephone_number": "860-944-7682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGASSE",
        "first_name": "HEIDI",
        "middle_name": "SARA",
        "name_prefix": "Mrs.",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-24",
        "last_updated": "2012-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "SC",
            "license": "3147",
            "primary": true
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "CT",
            "license": "000193",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2012; 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.