Individual provider Active NPI

Michelle Kloke

  • Occupational Therapist
  • Richfield, MN
National Provider Identifier
1346071990
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
104759 Issued in MN
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

Updated by the provider on Aug 13, 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 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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
104759MNMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Speech & Therapy Services, LLC Occupational Therapist CurrentSince Nov 11, 2024 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.

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.

Verify at the official NPI Registry.