Individual provider Active NPI

Nathan Opare-Addo, OTR

  • Occupational Therapist
  • Coon Rapids, MN
National Provider Identifier
1194450254
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
106825 Issued in MN
Practice address
4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522
Phone
(763) 236-6000
NPI assigned
Jul 21, 2022
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 106825 MN Primary

Addresses

Primary practice location

4050 Coon Rapids Blvd NW
Coon Rapids, MN 55433-2522

Mailing address

6931 Willow LN
Brooklyn Center, MN 55430-1339
Phone (763) 567-3881

Other practice location 1

6500 Excelsior Blvd
St Louis Park, MN 55426-4700
Phone (952) 993-5000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
106825MNMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1194450254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6931 WILLOW LN",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554301339",
            "telephone_number": "763-567-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 COON RAPIDS BLVD NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332522",
            "telephone_number": "763-236-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6500 Excelsior Blvd",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554264700",
            "country_code": "US",
            "telephone_number": "952-993-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OPARE-ADDO",
        "first_name": "NATHAN",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "106825",
            "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 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.