Individual provider Active NPI

Holly Osborn

  • Occupational Therapist
  • Fargo, ND
National Provider Identifier
1063765402
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
1486 Issued in ND
Practice address
3244 51St St S
Fargo, ND 58104-7179
Phone
(701) 356-0062
Fax
(701) 356-5412
NPI assigned
Oct 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X OT60034778 WA
Occupational Therapist 225X00000X 1486 ND Primary

Addresses

Primary practice location

3244 51St St S
Fargo, ND 58104-7179

Mailing address

3244 51St St S
Fargo, ND 58104-7179
Phone (701) 356-0062

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND, KY2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160926000565 ND Practitioner - Occupational Therapist in Private Practice 9638466204 Reassigns benefits to 1 organization
I20250911000922 KY Practitioner - Marriage and Family Therapist 9638466204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Beyond Boundaries Occupational Therapy IncGroup PAC ID 9133298599, 15 clinicians

Practice addresses (Care Compare)

3244 51St St S
Fargo, ND 58104-7179
Phone (701) 356-0062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1486NDMDAddiction (Substance Use Disorder) Counselor
OT60034778WAMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beyond Boundaries Speech Language Therapy, Inc. CurrentSince Apr 17, 2019 Accepting new patients
Jason Muzzillo, PLLC CurrentSince Jul 4, 2025 Accepting new patients
Beyond Boundaries Occupational Therapy, Inc. Occupational Therapist CurrentSince Apr 17, 2019 Accepting new patients

Locations

75 Cavalier Blvd
Ste 310
Florence, KY 41042
Phone (859) 212-3180

168 E Reynolds Rd
Ste 150
Lexington, KY 40517
Phone (859) 212-3180

3244 51st St S
Fargo, ND 58104
Phone (701) 356-0062

3001 11th St S
Fargo, ND 58103
Phone (701) 356-0062

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1063765402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3244 51ST ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047179",
            "telephone_number": "701-356-0062",
            "fax_number": "701-356-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3244 51ST ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581047179",
            "telephone_number": "701-356-0062",
            "fax_number": "701-356-5412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBORN",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "WA",
            "license": "OT60034778",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "1486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.