Individual provider Active NPI

Samantha McGurgan

  • Occupational Therapy Assistant
  • Saint Paul, MN
National Provider Identifier
1073379905
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
Practice address
434 Hayward Ave N
Saint Paul, MN 55128-5379
Phone
(651) 739-2300
NPI assigned
Feb 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X MN Primary

Addresses

Primary practice location

434 Hayward Ave N
Saint Paul, MN 55128-5379

Mailing address

4525 W 42ND St
Saint Louis Park, MN 55416-5266

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

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Speech, Language and Learning, Inc. CurrentSince Mar 3, 2024 Accepting new patients
Center for Speech, Language, and Learning, Inc. PastSince Mar 3, 2024 Accepting new patients

Locations

434 Hayward Ave N
Saint Paul, MN 55128
Phone (651) 739-2300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1708992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708992000000",
    "number": "1073379905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4525 W 42ND ST",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554165266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 HAYWARD AVE N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551285379",
            "telephone_number": "651-739-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGURGAN",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-27",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2024; 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.