Individual provider Active NPI

Kari Hope Kjergaard, OTR/L

  • Occupational Therapist
  • Edina, MN
National Provider Identifier
1205306867
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
105715 Issued in MN
Practice address
6515 Barrie Rd Ste 100
Edina, MN 55435-2364
Phone
(952) 922-1384
NPI assigned
Nov 27, 2018
Last updated
Nov 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 0005261 CO
Occupational Therapist 225X00000X 105715 MN Primary

Addresses

Primary practice location

6515 Barrie Rd Ste 100
Edina, MN 55435-2364

Mailing address

6515 Barrie Rd Ste 100
Edina, MN 55435-2364
Phone (952) 922-5019

Other identifiers 1

IdentifierTypeStateIssuer
050420579OtherCODRIVER'S LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200928002862 MN Practitioner - Occupational Therapist in Private Practice 7517386303 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0005261COMDOccupational Therapist
105715MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Novacare Outpatient Rehabilitation East Inc CurrentSince Jun 2, 2020 Accepting new patients
Novacare Outpatient Rehabilitation East Inc Current Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. CurrentSince Jun 2, 2020 Accepting new patients

Locations

10091 Dogwood St NW
Minneapolis, MN 55448
Phone (763) 450-0298

6515 Barrie Rd
Ste 100
Minneapolis, MN 55435
Phone (952) 922-1384

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": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1205306867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6515 BARRIE RD STE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352364",
            "telephone_number": "952-922-5019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 BARRIE RD STE 100",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554352364",
            "telephone_number": "952-922-1384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KJERGAARD",
        "first_name": "KARI",
        "middle_name": "HOPE",
        "credential": "OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "0005261",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "105715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVER'S LICENSE",
            "identifier": "050420579",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.