NPIMap

Organization Active NPI

Little Lights Pediatric Therapy, LLC

  • Occupational Therapist
  • Bismarck, ND
National Provider Identifier
1083121792
Registry record updated Nov 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Legal business name
LITTLE LIGHTS PEDIATRIC THERAPY, LLC
Practice address
1615 Capitol Way
Bismarck, ND 58501-2218
Phone
(701) 751-0410
NPI assigned
Jan 3, 2018
Last updated
Nov 17, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2022

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

Authorized official

Name
Krisann Miller, OTR/LNPI 1073750501
Title
Owner
Phone
(701) 751-0410

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Occupational Therapist 225X00000X Primary
Speech-Language Pathologist 235Z00000X

Addresses

Primary practice location

1615 Capitol Way
Bismarck, ND 58501-2218

Mailing address

1615 Capitol Way
Bismarck, ND 58501-2218
Phone (701) 751-0410

Other practice location 1

307 Main St
Strasburg, ND 58573-7142
Phone (701) 751-0410

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211104000335 ND Part B Supplier - Clinic/Group Practice 0143618595 Receives reassigned benefits from 4 practitioners
Practice locations: Bismarck, ND

National Provider Directory

National Provider Directory

Locations

1615 E Capitol Way
Bismarck, ND 58501
Phone (701) 204-7870

1615 E Capitol Way
Ste 100
Bismarck, ND 58501
Phone (701) 751-0410

4501 Coleman St
Ste 100
Bismarck, ND 58503
Phone (701) 751-0410

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668643200000",
    "number": "1083121792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 CAPITOL WAY",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585012218",
            "telephone_number": "701-751-0410",
            "fax_number": "855-834-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 CAPITOL WAY",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585012218",
            "telephone_number": "701-751-0410"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 Main St",
            "address_purpose": "LOCATION",
            "city": "Strasburg",
            "state": "ND",
            "postal_code": "585737142",
            "country_code": "US",
            "telephone_number": "701-751-0410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LITTLE LIGHTS PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-03",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "KRISANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "701-751-0410",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.