Individual provider Active NPI

Andria Nancy Ratliff

  • Occupational Therapy Assistant
  • Golden Valley, MN
National Provider Identifier
1083203863
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
2403 Issued in MN
Practice address
5800 Saint Croix Ave N
Golden Valley, MN 55422-4446
Phone
(612) 246-3592
NPI assigned
Jan 15, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X 2403 MN Primary

Addresses

Primary practice location

5800 Saint Croix Ave N
Golden Valley, MN 55422-4446

Mailing address

3452 Lake Lynda Dr Ste 200
Orlando, FL 32817-1481

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
2403MNMDCertified Registered Nurse Anesthetist

NPI Registry JSON

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1083203863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3452 LAKE LYNDA DR STE 200",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328171481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5800 SAINT CROIX AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224446",
            "telephone_number": "612-246-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RATLIFF",
        "first_name": "ANDRIA",
        "middle_name": "NANCY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "2403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Golden Valley, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2021; 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.