Active NPI
Lance David Zarimba, OT
- Occupational Therapist
- Coon Rapids, MN
National Provider Identifier
1124158753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 103204
- Practice address
- 2014 Northdale Blvd
Coon Rapids, MN 55433 - Phone
- (763) 755-5495
- Fax
- (763) 754-7077
- NPI assigned
- Mar 6, 2007
- 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 | 103204 | MN | Primary |
Addresses
Primary practice location
2014 Northdale Blvd
Coon Rapids, MN 55433
Mailing address
421 Upton Ave S
Minneapolis, MN 55405-1948
Phone (612) 623-1195
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)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173139200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1124158753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 UPTON AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554051948",
"telephone_number": "612-623-1195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2014 NORTHDALE BLVD",
"city": "COON RAPIDS",
"state": "MN",
"postal_code": "55433",
"telephone_number": "763-755-5495",
"fax_number": "763-754-7077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZARIMBA",
"first_name": "LANCE",
"middle_name": "DAVID",
"name_prefix": "Mr.",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "103204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coon Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.