Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Amanda Lane, OTR/L

Individual provider Occupational Therapist · NPI 1780248419

Amanda Lane, OTR/L is an Occupational Therapist in Private Practice in Waconia, Minnesota. Qualified in 2001, 25 years ago. Practices with Odom Sports Medicine PA, a 69-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
25
Licensed in
MN
In the registry since
2019
What do these letters mean?
OTR/L — Occupational Therapist, Registered and Licensed
An occupational therapist who is both nationally registered and state licensed.

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Practice location Address checks out

500 S Cherry St
Waconia, MN 55387-4515
Phone: (952) 856-4722
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 102717 (MN)

Record details

NPI number1780248419
Entity typeIndividual (Type 1)
GenderFemale
Credentials OTR/L
Sole proprietorNo
NPI enumeratedApril 29, 2019
Last updated in NPPESApril 29, 2019
Mailing address10653 Wayzata Blvd, Minnetonka, MN 55305-1528

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Odom Sports Medicine Pa — 69 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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