Individual provider Active NPI

Kristi Thoma, OTR/L

  • Occupational Therapist
  • Fergus Falls, MN
National Provider Identifier
1174989669
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
102733 Issued in MN
Practice address
1131 S Mabelle Ave
Fergus Falls, MN 56537-3723
Phone
(218) 998-1505
NPI assigned
Jan 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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 102733 MN Primary

Addresses

Primary practice location

1131 S Mabelle Ave
Fergus Falls, MN 56537-3723

Mailing address

1131 S Mabelle Ave
Fergus Falls, MN 56537-3723

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220412002513 MN Practitioner - Occupational Therapist in Private Practice 9436545837 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
102733MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Sports Physical Therapy, Inc. CurrentSince Dec 29, 2021 Accepting new patients
Orthopedic & Sports Physical Therapy, Inc CurrentSince Dec 29, 2021 Accepting new patients

Locations

430 5th St N
Breckenridge, MN 56520
Phone (218) 641-7725

73 Minnesota Ave
Breckenridge, MN 56520
Phone (218) 641-7725

322 N Tower Rd
Fergus Falls, MN 56537
Phone (218) 371-2843

2450 College Way
Fergus Falls, MN 56537
Phone (218) 998-2980

Organizations & group practices 2

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": "1452643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1174989669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1131 S MABELLE AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 S MABELLE AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565373723",
            "telephone_number": "218-998-1505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMA",
        "first_name": "KRISTI",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "102733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fergus Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.