Active NPI
Kelly Collins
- Occupational Therapist
- Duluth, MN
National Provider Identifier
1093027690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 103884
- Practice address
- 1378 Highland Village Dr
Apt 24
Duluth, MN 55811-5274 - Phone
- (763) 689-5385
- NPI assigned
- Jul 12, 2010
- Last updated
- Jul 12, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 103884 | MN | Primary |
Addresses
Primary practice location
1378 Highland Village Dr
Apt 24
Duluth, MN 55811-5274
Mailing address
1378 Highland Village Dr
Apt 24
Duluth, MN 55811-5274
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
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NSH Superior LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Twin Ports Health Services
- Skilled Nursing Facility
- Superior, WI
- NPI 1669914537
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1278892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278892800000",
"number": "1093027690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1378 HIGHLAND VILLAGE DR",
"address_2": "APT 24",
"city": "DULUTH",
"state": "MN",
"postal_code": "558115274"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1378 HIGHLAND VILLAGE DR",
"address_2": "APT 24",
"city": "DULUTH",
"state": "MN",
"postal_code": "558115274",
"telephone_number": "763-689-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLINS",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-12",
"last_updated": "2010-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "103884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.