Individual provider Active NPI

Kari Ellen Van Lanen, OTR

  • Occupational Therapist
  • De Pere, WI
National Provider Identifier
1912727595
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
4366-26 Issued in WI
Practice address
3852 Creamery Rd
De Pere, WI 54115-9210
Phone
(920) 338-9670
NPI assigned
Oct 16, 2024
Last updated
Oct 16, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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 4366-26 WI Primary

Addresses

Primary practice location

3852 Creamery Rd
De Pere, WI 54115-9210

Mailing address

2955 Flowering Peach Dr
Suamico, WI 54313-3225
Phone (920) 309-2451

Other names 1

  • Miss Kari Ellen Karwedsky Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241203002559 WI Practitioner - Occupational Therapist in Private Practice 6103351978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Andrews Physical Therapy SCGroup PAC ID 5092765214, 6 clinicians

Practice addresses (Care Compare)

3852 Creamery Rd
De Pere, WI 54115-9210
Phone (920) 338-9670

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4366-26WIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrews Physical Therapy, SC Occupational Therapist CurrentSince Oct 23, 2024 Accepting new patients

Locations

3852 Creamery Rd
De Pere, WI 54115
Phone (920) 338-9670

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729036800000",
    "number": "1912727595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 FLOWERING PEACH DR",
            "city": "SUAMICO",
            "state": "WI",
            "postal_code": "543133225",
            "telephone_number": "920-309-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3852 CREAMERY RD",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541159210",
            "telephone_number": "920-338-9670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN LANEN",
        "first_name": "KARI",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-16",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WI",
            "license": "4366-26",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KARI",
            "last_name": "KARWEDSKY",
            "middle_name": "ELLEN",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in De Pere, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.