Individual provider Active NPI

Abigail Dennis, OTR/L

  • Occupational Therapist
  • Burnsville, MN
National Provider Identifier
1346007275
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
107362 Issued in MN
Practice address
14451 Grand Ave
Burnsville, MN 55306-5708
Phone
(952) 993-5900
NPI assigned
Mar 6, 2024
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 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 107362 MN Primary

Addresses

Primary practice location

14451 Grand Ave
Burnsville, MN 55306-5708

Mailing address

5605 Blaisdell Ave
Minneapolis, MN 55419-1920
Phone (507) 581-3302

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240426001665 MN Practitioner - Occupational Therapist in Private Practice 2163862962 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107362MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic CurrentSince Mar 18, 2024 Accepting new patients
Park Nicollet Clinic CurrentSince Mar 12, 2024 Accepting new patients
Park Nicollet Clinic PastSince Mar 12, 2024 Accepting new patients

Locations

14451 Grand Ave S
Burnsville, MN 55306
Phone (701) 441-9496

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1709683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1346007275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5605 BLAISDELL AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554191920",
            "telephone_number": "507-581-3302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14451 GRAND AVE",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553065708",
            "telephone_number": "952-993-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "ABIGAIL",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "107362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burnsville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.