Active NPI
Krista R Dotseth, CTRS, HTP
- Recreation Therapist
- Waite Park, MN
National Provider Identifier
1235377730
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 54120
- Practice address
- 110 2ND St S Ste 234
Waite Park, MN 56387-1314 - Phone
- (763) 354-4468
- NPI assigned
- Jan 22, 2009
- Last updated
- Jan 29, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 54120 | MN | Primary |
Addresses
Primary practice location
110 2ND St S Ste 234
Waite Park, MN 56387-1314
Mailing address
811 2ND Ave
Albany, MN 56307-9468
Phone (763) 354-4468
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
| License | State | Type | Specialty |
|---|---|---|---|
| 54120 | MN | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738108800000",
"number": "1235377730",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "811 2ND AVE",
"city": "ALBANY",
"state": "MN",
"postal_code": "563079468",
"telephone_number": "763-354-4468"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 2ND ST S STE 234",
"city": "WAITE PARK",
"state": "MN",
"postal_code": "563871314",
"telephone_number": "763-354-4468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOTSETH",
"first_name": "KRISTA",
"middle_name": "R",
"credential": "CTRS, HTP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-22",
"last_updated": "2025-01-29",
"certification_date": "2025-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "MN",
"license": "54120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waite Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.