Individual provider Active NPI

Kinzie Elizabeth Eckstein, OTR/L

  • Mental Health Occupational Therapist
  • New Ulm, MN
National Provider Identifier
1043594252
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Occupational TherapistTaxonomy code 225XM0800X
License
140145 Issued in MN
Practice address
15 S Minnesota St
New Ulm, MN 56073-3056
Phone
(651) 964-5578
NPI assigned
Oct 6, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Occupational Therapist 225XM0800X 140145 MN Primary

Addresses

Primary practice location

15 S Minnesota St
New Ulm, MN 56073-3056

Mailing address

5842 Hobe LN
White Bear Lake, MN 55110-6477
Phone (651) 383-1197

Other names 1

  • Miss Kinzie Elizabeth Phillips Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
140145MNMDMental Health Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1043594252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5842 HOBE LN",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551106477",
            "telephone_number": "651-383-1197",
            "fax_number": "651-383-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 S MINNESOTA ST",
            "city": "NEW ULM",
            "state": "MN",
            "postal_code": "560733056",
            "telephone_number": "651-964-5578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKSTEIN",
        "first_name": "KINZIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-06",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": "MN",
            "license": "140145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KINZIE",
            "last_name": "PHILLIPS",
            "middle_name": "ELIZABETH",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Ulm, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.