Individual provider Active NPI

Kara Johnson

  • Pediatric Occupational Therapist
  • Fergus Falls, MN
National Provider Identifier
1205005741
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
104640 Issued in MN
Practice address
620 N Burlington Ave
Fergus Falls, MN 56537-2318
Phone
(701) 527-1834
NPI assigned
Feb 28, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 104640 MN Primary
Occupational Therapist 225X00000X 329 AK

Addresses

Primary practice location

620 N Burlington Ave
Fergus Falls, MN 56537-2318

Mailing address

620 N Burlington Ave
Fergus Falls, MN 56537-2318
Phone (701) 527-1834

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251107000735 MN Practitioner - Occupational Therapist in Private Practice 8921273244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

620 N Burlington Ave
Fergus Falls, MN 56537-2318

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
329AKMDChiropractor
104640MNMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shine Therapies for Kids Pediatrics CurrentSince Sep 1, 2025 Accepting new patients
Kenai Kids Therapy Inc Past Accepting new patients
Occupational Rehabilitative Services Inc Occupational Therapist Past Accepting new patients

Locations

125 S Mill St
Fergus Falls, MN 56537
Phone (701) 527-1834

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": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1205005741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N BURLINGTON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372318",
            "telephone_number": "701-527-1834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N BURLINGTON AVE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565372318",
            "telephone_number": "701-527-1834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "104640",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AK",
            "license": "329",
            "primary": false
        }
    ],
    "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 Jun 16, 2025; 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.