Individual provider Active NPI

Andrew Michael Aeshliman, COTA

  • Occupational Therapy Assistant
  • St Louis Park, MN
National Provider Identifier
1306609102
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
202354 Issued in MN
Practice address
5320 W 23Rd St Ste 130
St Louis Park, MN 55416-1670
Phone
(952) 345-8770
NPI assigned
Feb 5, 2024
Last updated
Feb 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X 202354 MN Primary

Addresses

Primary practice location

5320 W 23Rd St Ste 130
St Louis Park, MN 55416-1670

Mailing address

758 New Century Blvd S
Maplewood, MN 55119-5996

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
202354MNMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1707091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1306609102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 NEW CENTURY BLVD S",
            "city": "MAPLEWOOD",
            "state": "MN",
            "postal_code": "551195996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5320 W 23RD ST STE 130",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161670",
            "telephone_number": "952-345-8770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AESHLIMAN",
        "first_name": "ANDREW",
        "middle_name": "MICHAEL",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-05",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "MN",
            "license": "202354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Louis Park, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.