Individual provider Active NPI

Kelly Jo Ersland-Anderson, OTR/L

  • Pediatric Occupational Therapist
  • Hutchinson, MN
National Provider Identifier
1235688177
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
100719 Issued in MN
Practice address
20288 Highway 15 N
Suite 100
Hutchinson, MN 55350-5684
Phone
(320) 587-2326
Fax
(320) 234-6358
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Occupational Therapist 225XP0200X 100719 MN Primary

Addresses

Primary practice location

20288 Highway 15 N
Suite 100
Hutchinson, MN 55350-5684

Mailing address

20288 Highway 15 N
Suite 100
Hutchinson, MN 55350-5684
Phone (320) 587-2326

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

LicenseStateTypeSpecialty
100719MNMDPediatric Occupational Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1235688177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20288 HIGHWAY 15 N",
            "address_2": "SUITE 100",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553505684",
            "telephone_number": "320-587-2326",
            "fax_number": "320-234-6358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20288 HIGHWAY 15 N",
            "address_2": "SUITE 100",
            "city": "HUTCHINSON",
            "state": "MN",
            "postal_code": "553505684",
            "telephone_number": "320-587-2326",
            "fax_number": "320-234-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERSLAND-ANDERSON",
        "first_name": "KELLY",
        "middle_name": "JO",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "100719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hutchinson, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; 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.