Active NPI
Mary Ann Nelson, OTR/L
- Occupational Therapist
- Little Canada, MN
National Provider Identifier
1235664327
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 104758
- Practice address
- 75 W Viking Drive
Suite101
Little Canada, MN 55117 - Phone
- (651) 766-0080
- NPI assigned
- Apr 26, 2017
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 104758 | MN | Primary |
Addresses
Primary practice location
75 W Viking Drive
Suite101
Little Canada, MN 55117
Mailing address
2658 Bartylla CT
White Bear Township, MN 55110-3503
Phone (651) 308-5923
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1493164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493164800000",
"number": "1235664327",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2658 BARTYLLA CT",
"city": "WHITE BEAR TOWNSHIP",
"state": "MN",
"postal_code": "551103503",
"telephone_number": "651-308-5923"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 W VIKING DRIVE",
"address_2": "SUITE101",
"city": "LITTLE CANADA",
"state": "MN",
"postal_code": "55117",
"telephone_number": "651-766-0080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NELSON",
"first_name": "MARY ANN",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-26",
"last_updated": "2017-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "104758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Canada, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.