Individual provider Active NPI

Megan Wetterling, MA OTR/L

  • Occupational Therapist
  • Maplewood, MN
National Provider Identifier
1093166431
Registry record updated Jul 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
105052 Issued in MN
Practice address
2945 Hazelwood St Ste 320
Maplewood, MN 55109-1244
Phone
(651) 683-7030
NPI assigned
Jun 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X
Occupational Therapist 225X00000X 105052 MN Primary

Addresses

Primary practice location

2945 Hazelwood St Ste 320
Maplewood, MN 55109-1244

Mailing address

2030 Rahn Way
Eagan, MN 55122-2300

Other practice location 1

2030 Rahn Way
Eagan, MN 55122
Phone (612) 767-7222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190822000441 MN Practitioner - Occupational Therapist in Private Practice 2860720398 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
105052MNMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Healtheast Outpatient Services, LLC Occupational Therapist CurrentSince Oct 1, 2020 Accepting new patients
Fairview Express Care CurrentSince Aug 30, 2019 Accepting new patients
Fairview Health Services CurrentSince Aug 30, 2019 Accepting new patients

Locations

3305 Central Park Village Dr
Ste 130
Eagan, MN 55121
Phone (651) 406-8701

2945 Hazelwood St
Ste 320
Maplewood, MN 55109
Phone (612) 273-1172

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

2450 Riverside Ave
Minneapolis, MN 55454
Phone (612) 273-7838

9220 Bass Lake Rd
Ste 260
New Hope, MN 55428
Phone (763) 533-0363

911 Northland Dr
Princeton, MN 55371
Phone (763) 389-1313

1390 University Ave W
Saint Paul, MN 55104
Phone (651) 232-4800

1825 Woodwinds Dr
Woodbury, MN 55125
Phone (651) 232-6700

9680 Tamarack Rd
Ste 130
Woodbury, MN 55125
Phone (612) 273-1172

Organizations & group practices 5

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564099200000",
    "number": "1093166431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 RAHN WAY",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 HAZELWOOD ST STE 320",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551091244",
            "telephone_number": "651-683-7030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2030 Rahn Way",
            "address_purpose": "LOCATION",
            "city": "Eagan",
            "state": "MN",
            "postal_code": "55122",
            "country_code": "US",
            "telephone_number": "612-767-7222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WETTERLING",
        "first_name": "MEGAN",
        "credential": "MA OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2019-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maplewood, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2019; 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.