Individual provider Active NPI

Olivia Zoner, OT, D

  • Occupational Therapist
  • Shoreview, MN
National Provider Identifier
1275314957
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
Practice address
490 Highway 96 W
Suite 300
Shoreview, MN 55126
Phone
(651) 451-3016
Fax
(651) 481-7040
NPI assigned
Oct 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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 MN Primary

Addresses

Primary practice location

490 Highway 96 W
Suite 300
Shoreview, MN 55126

Mailing address

1050 Cox Farm Road
Long Lake, MN 55356
Phone (952) 334-3906

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240103004180 MN Practitioner - Occupational Therapist in Private Practice 8123479136 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107345MNMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kids Abilities, Inc. CurrentSince Nov 21, 2023 Accepting new patients
Kids Abilities, Inc CurrentSince Nov 21, 2023 Accepting new patients

Locations

4638 Victor Path
Ste 100
Hugo, MN 55038
Phone (651) 407-3777

490 Highway 96 W
Shoreview, MN 55126
Phone (651) 415-5490

490 Highway 96 W
Ste 300
Shoreview, MN 55126
Phone (651) 451-3016

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1696896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1275314957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 COX FARM ROAD",
            "city": "LONG LAKE",
            "state": "MN",
            "postal_code": "55356",
            "telephone_number": "952-334-3906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 HIGHWAY 96 W",
            "address_2": "SUITE 300",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "55126",
            "telephone_number": "651-451-3016",
            "fax_number": "651-481-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZONER",
        "first_name": "OLIVIA",
        "credential": "OT, D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-10",
        "last_updated": "2023-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.