Active NPI
Michelle Kloke
- Occupational Therapist
- Richfield, MN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 104759
- Practice address
- 6625 Lyndale Ave S
Richfield, MN 55423-2373 - Phone
- (952) 285-2840
- NPI assigned
- Aug 13, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 104759 | MN | Primary |
Addresses
Primary practice location
6625 Lyndale Ave S
Richfield, MN 55423-2373
Mailing address
6625 Lyndale Ave S
Richfield, MN 55423-2373
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241028000419 | MN | Practitioner - Occupational Therapist in Private Practice | 9931632163 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104759 | MN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Speech & Therapy Services, LLC | Occupational Therapist | Current | Accepting new patients |
Locations
1891 Station Pkwy NW
Andover, MN 55304
Phone (763) 307-4589
2649 W 78th St
Chanhassen, MN 55317
Phone (507) 601-6300
11100 86th Ave N
Maple Grove, MN 55369
Phone (612) 418-4324
10611 Baltimore St NE
Ste 200
Minneapolis, MN 55449
Phone (763) 290-1985
15590 90th St NE
Otsego, MN 55330
Phone (763) 308-3869
4301 Highway 7
Ste 155
St Louis Park, MN 55416
Phone (763) 755-4261
Organizations & group practices 1
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.
-
- Speech-Language Pathologist
- Andover, MN
- NPI 1235285966
MN, Occupational Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1723507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1723507200000",
"number": "1346071990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6625 LYNDALE AVE S",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554232373"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6625 LYNDALE AVE S",
"city": "RICHFIELD",
"state": "MN",
"postal_code": "554232373",
"telephone_number": "952-285-2840"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLOKE",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-08-13",
"last_updated": "2024-08-13",
"certification_date": "2024-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MN",
"license": "104759",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Richfield, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.