Individual provider Active NPI

Kelly Greeninger, OTR/L

  • Hand Occupational Therapist
  • Plymouth, MN
National Provider Identifier
1033874672
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
106700 Issued in MN
Practice address
15700 37TH Ave N Ste 220
Plymouth, MN 55446-3399
Phone
(651) 968-5600
NPI assigned
Nov 8, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 106700 MN Primary

Addresses

Primary practice location

15700 37TH Ave N Ste 220
Plymouth, MN 55446-3399

Mailing address

710 Commerce Dr Ste 200
Woodbury, MN 55125-4925
Phone (651) 968-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211116000241 MN Practitioner - Occupational Therapist in Private Practice 0749679652 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Orthopedics, LTDGroup PAC ID 8921900374, 282 clinicians

Practice addresses (Care Compare)

15700 37TH Ave N
Suite 150
Plymouth, MN 55446-3675
Phone (651) 968-5201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Orthopedics, LTD Hand CurrentSince Nov 29, 2021 Accepting new patients
Summit Orthopedics LTD CurrentSince Nov 29, 2021 Accepting new patients
Ilbnc, P.a. Past Accepting new patients

Locations

15700 37th Ave N
Ste 220
Plymouth, MN 55446
Phone (651) 968-5600

15700 37th Ave N
Ste 150
Plymouth, MN 55446
Phone (651) 968-1627

1661 Saint Anthony Ave
Saint Paul, MN 55104
Phone (651) 968-5300

710 Commerce Dr
Ste 200
Woodbury, MN 55125
Phone (651) 968-5042

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1636329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1033874672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 37TH AVE N STE 220",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554463399",
            "telephone_number": "651-968-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENINGER",
        "first_name": "KELLY",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-08",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MN",
            "license": "106700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.