Active NPI
Olivia Renee Lake, OTR/L
- Occupational Therapist
- Appleton, WI
National Provider Identifier
1891490116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 8169-26
- Practice address
- 1101 E South River St
Appleton, WI 54915-2223 - Phone
- (920) 830-9911
- NPI assigned
- Apr 4, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 8169-26 | WI | Primary |
Addresses
Primary practice location
1101 E South River St
Appleton, WI 54915-2223
Mailing address
228 Crestview Cir
Wrightstown, WI 54180-1078
Phone (920) 450-4034
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8169-26 | WI | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PRN Home Health & Therapy, LLC | Current | Accepting new patients |
Locations
1101 E South River St
Appleton, WI 54915
Phone (920) 830-9911
Organizations & group practices 1
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.
-
- Home Health Agency
- Appleton, WI
- NPI 1396111068
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752710400000",
"number": "1891490116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "228 CRESTVIEW CIR",
"city": "WRIGHTSTOWN",
"state": "WI",
"postal_code": "541801078",
"telephone_number": "920-450-4034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 E SOUTH RIVER ST",
"city": "APPLETON",
"state": "WI",
"postal_code": "549152223",
"telephone_number": "920-830-9911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAKE",
"first_name": "OLIVIA",
"middle_name": "RENEE",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-04",
"last_updated": "2025-07-17",
"certification_date": "2025-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "WI",
"license": "8169-26",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.