Sam Adam Maki, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

107023 Issued in MN

Practice address

825 1St Ave NW
New Brighton, MN 55112-6846

Phone

(651) 633-7875

NPI assigned

Dec 14, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1255043949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23885 ASPEN DR",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553748757",
            "telephone_number": "763-267-8266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 1ST AVE NW",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551126846",
            "telephone_number": "651-633-7875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKI",
        "first_name": "SAM",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-12-14",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Charles Lusk, LPCC
• Kristine L. Lutz, MA, LMFT
• Olivia Katherine Maciej, LPCC
• Rachel Lynn Mack, PSY.D, L.P.
• Robin B Mahan, MA, LMFT
• Heather Mantsch, CNP
• Mark E. Anderson Family LTD
• Marleen Noel Marks Meyer, MSSW, LICSW
• Emily Markstrom, B.S.
• Amy Marie Markuson, LGSW

• Occupational Therapist in New Brighton, MN
• Providers in New Brighton, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2022; 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.