Individual provider Active NPI

Allie Jo Reiffenberger, OTD, OTR/L

  • Occupational Therapist
  • Crookston, MN
National Provider Identifier
1063396034
Registry record updated Aug 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107902 Issued in ND
Practice address
323 S Minnesota St
Crookston, MN 56716-1601
Phone
(218) 281-9200
NPI assigned
Aug 4, 2025
Last updated
Aug 22, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2025

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 107902 ND Primary

Addresses

Primary practice location

323 S Minnesota St
Crookston, MN 56716-1601

Mailing address

3170 Gateway Dr Ste a
Grand Forks, ND 58203-7532
Phone (320) 305-2350

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107902NDMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1754265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755820800000",
    "number": "1063396034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3170 GATEWAY DR STE A",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582037532",
            "telephone_number": "320-305-2350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161601",
            "telephone_number": "218-281-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REIFFENBERGER",
        "first_name": "ALLIE",
        "middle_name": "JO",
        "credential": "OTD, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-04",
        "last_updated": "2025-08-22",
        "certification_date": "2025-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "107902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crookston, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2025; 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.