Lacey Lynn Opperud Konickson, MOT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103465 Issued in MN

Practice address

3001 Sanford Pkwy
Thief River Falls, MN 56701-2700

Phone

(701) 780-5000

Fax

(701) 780-1942

NPI assigned

Jul 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Lacey Lynn Opperud Pahlen Former name

Medicare fee-for-service enrollment

Enrolled in ND, MN2 enrollments

Enrollment records 2

Merit-based Incentive Payment System (MIPS)

Final score

82.73 of 100Reported as group

Quality

71.75

Promoting interoperability

100

Improvement activities

40

Cost

70.68

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Sanford Medical Center Fargo

  dba Sanford 1717 Medical Building

  • Family Medicine Physician
  • West Fargo, ND
  • NPI 1184917924

  MN, Occupational Therapist

  Medicare reassignment NPD
• Sanford Medical Center Fargo

  dba Sanford LaMoure Clinic

  • Rural Health Clinic/Center
  • Lamoure, ND
  • NPI 1164439196
  NPD
• Sanford Medical Center Fargo

  dba Sanford POWER Center

  • General Acute Care Hospital
  • Fargo, ND
  • NPI 1528009412
  NPD

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

{
    "created_epoch": "1185753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1073703690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-9419",
            "fax_number": "701-780-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SANFORD PKWY",
            "city": "THIEF RIVER FALLS",
            "state": "MN",
            "postal_code": "567012700",
            "telephone_number": "701-780-5000",
            "fax_number": "701-780-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONICKSON",
        "first_name": "LACEY",
        "middle_name": "LYNN OPPERUD",
        "name_prefix": "Mrs.",
        "credential": "MOT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-30",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LACEY",
            "last_name": "PAHLEN",
            "middle_name": "LYNN OPPERUD",
            "prefix": "MISS",
            "credential": "MOT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Steven Lee Keogh, D.C.
• Jawad H Khan, MD
• Wendy Lyn Kjersten
• Kristina Anne Kjos, R.N.
• Roy Taylor Klossner, MD
• Alexa Kovar, PA-C
• Keegan Krantz, LPC
• Rachel Kreitzer, LICSW
• Daniel James Kucera, O.T.
• Trell Ann Kulju, MA, LPCC

• Occupational Therapist in Thief River Falls, MN
• Providers in Thief River Falls, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.