Individual provider Active NPI

Treena Radermacher, OT

  • Occupational Therapist
  • Gwinner, ND
National Provider Identifier
1093744377
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
619 Issued in ND
Practice address
11 North Main St
Gwinner, ND 58040-0586
Phone
(701) 678-2244
Fax
(701) 678-2210
NPI assigned
Jun 30, 2006
Last updated
Feb 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 619 ND Primary

Addresses

Primary practice location

11 North Main St
Gwinner, ND 58040-0586

Mailing address

11 North Main St
Gwinner, ND 58040-0586
Phone (701) 678-2244

Other identifiers 1

IdentifierTypeStateIssuer
51062MedicaidND

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101019001281 ND Practitioner - Occupational Therapist in Private Practice 1951594266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mobilityplus Rehabilitation LTDGroup PAC ID 3072517911, 10 clinicians

Practice addresses (Care Compare)

11 N Main St
Gwinner, ND 58040-4001
Phone (701) 678-2244

110 Hillcrest Dr
Enderlin, ND 58027-1129
Phone (701) 437-3782

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mobilityplus Rehabilitation, LTD Occupational Therapist CurrentSince May 1, 2010 Accepting new patients
Mobilityplus Rehabilitation LTD Occupational Therapist Current Accepting new patients
Mobilityplus Rehabilitation, LTD Occupational Therapist CurrentSince May 1, 2010 Accepting new patients

Locations

11 N Main St
Gwinner, ND 58040
Phone (701) 678-2244

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1093744377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 NORTH MAIN ST",
            "city": "GWINNER",
            "state": "ND",
            "postal_code": "580400586",
            "telephone_number": "701-678-2244",
            "fax_number": "701-678-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 NORTH MAIN ST",
            "city": "GWINNER",
            "state": "ND",
            "postal_code": "580400586",
            "telephone_number": "701-678-2244",
            "fax_number": "701-678-2210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADERMACHER",
        "first_name": "TREENA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "ND",
            "license": "619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "51062",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gwinner, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.