Individual provider Active NPI

Sophia Grace Burch, OTR/L

  • Hand Occupational Therapist
  • Minneapolis, MN
National Provider Identifier
1235796723
Registry record updated May 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hand Occupational TherapistTaxonomy code 225XH1200X
License
105988 Issued in MN
Practice address
909 Fulton St SE
Minneapolis, MN 55455-4800
Phone
(612) 623-7814
NPI assigned
May 21, 2019
Last updated
May 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hand Occupational Therapist 225XH1200X 105988 MN Primary

Addresses

Primary practice location

909 Fulton St SE
Minneapolis, MN 55455-4800

Mailing address

909 Fulton St SE
Minneapolis, MN 55455-4800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190529000776 MN Practitioner - Occupational Therapist in Private Practice 8426391814 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fairview Express CareGroup PAC ID 3375645179, 1,946 clinicians

Practice addresses (Care Compare)

14101 Fairview Dr
Suite 300
Burnsville, MN 55337-2537
Phone (952) 460-4900

717 Delaware St SE
Suite 340
Minneapolis, MN 55414-2959
Phone (612) 672-7422

Merit-based Incentive Payment System (MIPS)

Final score
88.63 of 100Reported as group
Quality
75.41
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105988MNMDHand Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients
Fairview Express Care CurrentSince May 13, 2019 Accepting new patients
Fairview Health Services CurrentSince May 13, 2019 Accepting new patients
Fairview Express Care CurrentSince Mar 1, 2020 Accepting new patients

Locations

15650 Cedar Ave
Ste 160
Apple Valley, MN 55124
Phone (952) 997-4170

1750 105th Ave NE
Blaine, MN 55449
Phone (763) 780-0356

14101 Fairview Dr
Ste 300
Burnsville, MN 55337
Phone (612) 273-5400

6341 University Ave NE
Ste 104
Fridley, MN 55432
Phone (763) 572-4946

14712 Victor Hugo Blvd N
Hugo, MN 55038
Phone (651) 466-1900

10000 Zane Ave N
Minneapolis, MN 55443
Phone (763) 528-6999

10961 Club West Pkwy
Ste 200
Minneapolis, MN 55449
Phone (763) 528-2987

3033 Excelsior Blvd
Ste 225
Minneapolis, MN 55416
Phone (612) 672-7000

400 Stinson Blvd
Fl 2
Minneapolis, MN 55413
Phone (612) 672-2203

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

2600 39th Ave NE
Ste 220
Saint Anthony, MN 55421
Phone (612) 672-7100

Organizations & group practices 7

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": "1558396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558396800000",
    "number": "1235796723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 FULTON ST SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554554800",
            "telephone_number": "612-623-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURCH",
        "first_name": "SOPHIA",
        "middle_name": "GRACE",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-21",
        "last_updated": "2019-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XH1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Hand",
            "state": "MN",
            "license": "105988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.