Individual provider Active NPI

Jessica Leigh Naiberg, MS OTR/L

  • Occupational Therapist
  • Blaine, MN
National Provider Identifier
1215208939
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
11800 Aberdeen St NE Ste 120
Blaine, MN 55449-4811
Phone
(612) 200-0704
NPI assigned
Jan 26, 2012
Last updated
Aug 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

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 NU Primary

Addresses

Primary practice location

11800 Aberdeen St NE Ste 120
Blaine, MN 55449-4811

Mailing address

11800 Aberdeen St NE Ste 120
Blaine, MN 55449-4811

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)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Berg Therapy, LLC Occupational Therapist CurrentSince Jul 13, 2025 Accepting new patients

Locations

11800 Aberdeen St NE
Ste 120
Blaine, MN 55449
Phone (612) 200-0704

Organizations & group practices 1

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": "1327536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1215208939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11800 ABERDEEN ST NE STE 120",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11800 ABERDEEN ST NE STE 120",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554494811",
            "telephone_number": "612-200-0704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAIBERG",
        "first_name": "JESSICA",
        "middle_name": "LEIGH",
        "credential": "MS OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-26",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; 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.