Individual provider Active NPI

Bridget Jae Reuss, OTR

  • Occupational Therapist
  • New London, MN
National Provider Identifier
1235947185
Registry record updated Dec 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107308 Issued in MN
Practice address
500 Peterson Pkwy
New London, MN 56273-7838
Phone
(952) 955-2242
Fax
(952) 955-2010
NPI assigned
Dec 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2024

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 107308 MN Primary

Addresses

Primary practice location

500 Peterson Pkwy
New London, MN 56273-7838

Mailing address

19 Central Ave
Buffalo, MN 55313-1569
Phone (922) 955-2242

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
107308MNMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1734998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734998400000",
    "number": "1235947185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 CENTRAL AVE",
            "city": "BUFFALO",
            "state": "MN",
            "postal_code": "553131569",
            "telephone_number": "922-955-2242",
            "fax_number": "952-955-2010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 PETERSON PKWY",
            "city": "NEW LONDON",
            "state": "MN",
            "postal_code": "562737838",
            "telephone_number": "952-955-2242",
            "fax_number": "952-955-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REUSS",
        "first_name": "BRIDGET",
        "middle_name": "JAE",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-24",
        "last_updated": "2024-12-24",
        "certification_date": "2024-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2024; 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.