Lisa Van Heukelom, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

1538 Issued in ND

Practice address

4530 Northern Sky Dr
Bismarck, ND 58503-8534

Phone

(701) 751-6336

NPI assigned

May 22, 2017

Last updated

Jun 5, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Pediatric Therapy Partners, Inc.

  dba Pediatric Partners

  • Occupational Therapist
  • Thief River Falls, MN
  • NPI 1457479958

  ND

  Medicare reassignment
• Red Door Pediatric Therapy, Inc

  dba Red Door Pediatric Therapy

  • Speech-Language Pathologist
  • Bismarck, ND
  • NPI 1639257033

  Occupational Therapist

  NPD (past)

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1942737820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 EASTVIEW DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585013279",
            "telephone_number": "701-426-0755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4530 NORTHERN SKY DR",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585038534",
            "telephone_number": "701-751-6336"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2625 N 19th St",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585030574",
            "country_code": "US",
            "telephone_number": "701-222-3175",
            "fax_number": "701-222-3186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAN HEUKELOM",
        "first_name": "LISA",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-22",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Uwase
• Kristy Susanne Vadnais, PHARMD
• Courtney Vaira, PH.D., LPCC-S, NCC
• Valerie Anne Drake DDS PLLC
• Kay A Van Erem, DDS
• Aaron G Van Ningen, M.D.
• Julie Van Voorhis
• Kylee R Vance, LPCC, LMAC
• Vancleave Chiropractic P.C.
• Sarah Lee Vancleave, D.C.

• Occupational Therapist in Bismarck, ND
• Providers in Bismarck, ND by specialty
• Occupational Therapist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.