Elizabeth Juanita Duffy, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103660 Issued in MN

Practice address

4707 Highway 61 N
# 150
White Bear Lake, MN 55110-3227

Phone

(608) 322-2722

NPI assigned

May 29, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

University of Wisconsin School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Roots and Wings Therapeutic Services LLCGroup PAC ID 4284027806, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Roots and Wings Therapeutic Services LLC

  • Occupational Therapist
  • Rogers, MN
  • NPI 1902564420
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1124286786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 RANDY AVE",
            "city": "WHITE BEAR TOWNSHIP",
            "state": "MN",
            "postal_code": "551104523",
            "telephone_number": "608-322-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 HIGHWAY 61 N",
            "address_2": "# 150",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103227",
            "telephone_number": "608-322-2722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3550 Airport Way",
            "address_2": "Suite 4",
            "address_purpose": "LOCATION",
            "city": "Fairbanks",
            "state": "AK",
            "postal_code": "997094760",
            "country_code": "US",
            "telephone_number": "907-374-4911",
            "fax_number": "907-374-4934",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUFFY",
        "first_name": "ELIZABETH",
        "middle_name": "JUANITA",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-29",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "1934",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Betsy Lynn Doucette
• Margaret Mary Downey, OTR L
• Allison Downs
• Dr.Crandall D.D.S
• Taylor Nessa Draves
• Kimberly Duffy, RDN, LD, CPT
• Audrey Elizabeth Dufresne
• Lindsay Duncan
• Dale J Duthoy, MD
• Jessica Dutton, ATC

• Occupational Therapist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.