Kristin Lynn Connell, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

103281 Issued in MN

Practice address

1891 Station Parkway
Andover, MN 55304

Phone

(763) 755-4275

Fax

(763) 755-4261

NPI assigned

Sep 14, 2006

Last updated

Nov 24, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Kristin Lynn Peterson Former name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Family Speech & Therapy Services, LLC

  dba Sora Pediatric Therapy

  • Speech-Language Pathologist
  • Andover, MN
  • NPI 1235285966
  Medicare reassignment

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416787200000",
    "number": "1336244375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 STATION PARKWAY",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "55304",
            "telephone_number": "763-755-4275",
            "fax_number": "763-755-4261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 STATION PARKWAY",
            "city": "ANDOVER",
            "state": "MN",
            "postal_code": "55304",
            "telephone_number": "763-755-4275",
            "fax_number": "763-755-4261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNELL",
        "first_name": "KRISTIN",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2014-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "103281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "PETERSON",
            "middle_name": "LYNN",
            "prefix": "MISS",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Columbia Park Medical Group, PA
• Columbia Park Medical Group, PA
• Columbia Park Medical Group, PA
• Gracie Isabella Comeau
• Community Services of Minnesota Inc
• Conscious Healing Counseling Inc
• Melissa Kay Craig, M.D.
• Courtney Erin Crawford, PHARMD
• Custom Smiles Dentistry, PLLC (Custom Smiles Dentistry)
• Mitchell Daas

• Occupational Therapist in Andover, MN
• Providers in Andover, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2014; 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.